New Process and Device for Minimal Invasive Surgical Suturing

One of the most challenging tasks in minimal invasive surgeries is the knotting of suture strands due to the lack of space for performing a free hand knotting. Furthermore, the differences between knotting performances of each individual surgeon, sutures are barely uniform from one closure to the other or even from one surgery to another. This may result in suboptimal healing processes due to insufficiencies or dead tissue at the wound area leading to necessary reoperations. Therefore, a new process and device has been developed by the Fraunhofer-Institute for Production Technology to replace conventional knots in minimal invasive surgeries by a new laser welding process. In this paper, the process concept, which is based on small fasteners, will be presented. After some insights on the design and production of the fasteners, results from proof-of-concept experiments will be discussed, which show the outstanding robustness and reproducibility of the welding process. In conclusion, a first prototype of a corresponding minimal invasive suturing device will be presented that has successfully been tested in first laboratory experiments. The new process and device for minimal invasive surgical suturing promises to enable an easier, faster, more reproducible, more uniform, and more sufficient performance of sutures with defined suture tensioning compared with conventional, difficult knotting procedures.