Multi-DOF (Degree of Freedom) Articulating Laparoscopic Instrument is an Effective Device in Performing Challenging Sutures

PURPOSE: Although laparoscopic surgery had been performed in clinical practice for over 30 years, there has not been much improvement on instruments. Several articulating laparoscopic instruments have been developed including the robotic system. A new multi-degree of freedom (DOF) articulating laparoscopic device has been developed. We compared the ability to perform challenging sutures between the new device and the robotic system. METHODS: Five experienced surgeons with over 100 laparoscopic surgery cases performed the suture task with both instruments. Everyone was new at articulating instruments including a robotic system. The suturing task consisted of two vertical sutures, downward and upward vertical direction. The duration of needle grabbing, first surgical tie, square tie, and the final reverse tie was measured. RESULTS: When doing the downward suture, the median time to complete the suture was 127 vs. 136 seconds for ArtiSential(®) and the robot, respectively (p=0.754). Other measurements such as needle grabbing, first tie, second tie and final knot did not show any significant difference between the two instruments. Upward suture also did not show a significant difference. The total completion time was 127 vs. 112 seconds for for ArtiSential(®) and the robot, respectively (p=0.675). Time taken in each interval did not show any significant difference. CONCLUSION: Both instruments performed the suturing tasks with no difference in duration. ArtiSential(®) can be mixed up with usual instruments. Surgeons can choose any device, but when articulation is needed, ArtiSential(®) could be an alternative choice to the robotic system.