Development And Effect Of A Novel Automatic Stapling Device For Knotless Barbed Suture In Laparoscopic Surgery

Objective: Based on the difficulty of suturing involved in laparoendoscopic single-site surgery,this study designed and fabricated a novel automatic stapling device for knotless barbed suture which is used in laparoscopic surgery.To a certain extent,the new device can overcome the technical problems of suture involved laparoendoscopic single-site surgery,so as to achieve rapid,continuous and stable suture during surgery.The feasibility and safety of this new device were evaluated by designing some evaluation experiments.At the same time,it provides a certain experimental basis for its clinical application.Methods: In collaboration with other disciplines,we have developed a novel automatic stapling device for knotless barbed suture in laparoscopic surgery.At the same time,we also applied it in relevant patents.In vitro experiments: We preliminarily verified the safety of this automatic stapling device in laparoscopic surgery by designing in vitro experiments for intestinal defects.In vivo experiments: The 21 experimental rabbits were divided into three groups before surgery: group A(execution on the 3rd day after molding),group B(execution on the 7th day after molding),and group C(execution on the 14 th day after molding).Each experimental rabbit established a model of skin and peritoneal lesions on the left side and a model of skin and peritoneal defects on the right side.The left defect was sutured by the new automatic stapling device,and the right defect was sutured with an ordinary needle holder.The safety and efficacy of the new automatic stapling device were evaluated by comparing the suture time of defects,general observation of postoperative tissue,HE staining microscopic observation,and comparison of HE staining scores.Results: In vitro experiments: A negative water leakage test of in vitro intestinal defect model was preliminarily demonstrated the safety of the new automatic stapling device.In vivo experiments: In new automatic stapling device group,the median suturing time of skin defects was 169.00(155.00-189.00)s,and the mean time was(172.86 ± 23.23)s,the median suturing time of abdominal model defects is 102.00(91.00-126.50)s,and the mean time was(112.00 ± 35.49)s;In ordinary needle holder suture group,the median suturing time of skin defects was 231.00(215.50-251.00)s,and the mean time was(231.76 ± 40.09)s,the median suturing time of peritoneal defects was 144.00(113.50-154.50)s,and the mean time was(139.71 ± 29.05)s;Compared with the ordinary needle holder suturing group,the difference between skin and peritoneal defects suturing time was statistically significant in the new automatic stapling device for knotless barbed suture in laparoscopic surgery(p < 0.05).Generally observed,the two suture methods have good tissue incision pairs;In group A and B,the automatic suture sutures were stitched with less inflammatory cell infiltration and lower inflammatory response scores than those of ordinary needle holders,and the difference was statistically significant(p < 0.05).Conclusion: Through in vivo and in vitro experimental studies,it was preliminarily proved that it was safe and feasible to apply the new automatic stapling device for knotless barbed suture in laparoscopic surgery for tissue suturing;Compared with ordinary needle holder sutures,the new automatic stapling device takes less time to achieve precise and effective sutures,causing a smaller inflammatory response during the proliferation period in the early stage of tissue healing;The overall process of tissue incision healing is the same in the two methods;The first sample has certain defects and needs to be optimized and improved;Subsequent animal experiments still need to be supplemented for verification.