Use of an automated endoscopic suturing device does not improve mental workload or time of intracorporeal suturing among surgical residents.

OBJECTIVE

To compare 2 intracorporeal suturing techniques among surgical residents.

METHODS

Surgical residents at an academic teaching hospital were invited to participate. All participants completed 2 intracorporeal suturing trials in a laparoscopic trainer using either endoscopic needle drivers (END) or an automated endoscopic suturing device (ESD), with 14 days between trials. A standardized, descriptive video of each intracorporeal suturing technique was provided 7 days before the respective trial. Time to perform suturing was recorded, and participants completed a National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire following each trial. Suture lines were subjectively blindly scored using a standardized questionnaire by 3 surgeons.

RESULTS

10 surgical residents across 4 years of training were enrolled. Mean time to complete the suturing trial was 5.72 ± 1.49 minutes for END and 6.00 ±2.14 minutes for ESD (P = .76). The mean NASA-TLX score was 44.60 ± 19.02 for END and 44.33 ± 22.22 for ESD (P = .83). Median suture evaluation score was 11 (IQR, 8 to 11) for END and 11 (IQR, 9 to 11) for ESD (P = .13). Mean time to perform suturing was significantly different across years of training in residency for both ESD and END (P = .006).

CONCLUSIONS

In this ex vivo model, an automated ESD provided no benefit for ease of performing intracorporeal suturing among surgical residents.

CLINICAL RELEVANCE: Surgical residents can perform intracorporeal suturing with knotless barbed suture using either ESD or END. Further evaluation of the learning curve of each instrument for novice surgeons is warranted.