Building on knowledge
Suture-TOOL has been developed for swift and standardized abdominal wall closure. The technology is developed from a clinical need and experience and have research-based evidence with proof of concept in various pre-clinical models.
Abdominal wall closure
The published results indicates that the new instrument is working rapid and delivers the same high performance regardless of the clinicians’ experience. Early feedback also shows that the instrument is intuitive and feels easy in the hand.
Surgeons can reduce abdominal wall complications by adhering to standardized techniques for abdominal wall closure.1 A safe standardized access and closure technique is wanted to minimize abdominal wall complications like wound infections, burst abdomen and incisional hernias.
It is recommended that the suture length-to-wound length (SL/WL) ratio is 4:1 and that the ratio is acquired with small stitches put tightly.2
This can be time-consuming and difficult to achieve especially following long trying surgical procedures.3
To address this issue, a Suture-TOOL has been developed for swift and standardized abdominal wall closure. The aim for the two studies that have been conducted was to compare the user safety, speed, and suturing quality between suture-TOOL and manual needle driver suturing (NDS), and to develop and evaluate a new suture device for standardized wound closure. A needle driver (Mayo-Hegar 16 cm, Stille AB, Sweden) and a 36-mm-semicurved CT-1 1/2 circle taper-point PDS II needle (Ethicon, Sommerville, NJ, USA) was used to produce the manual suturing.3
30% faster with the Suture Tool
The result of the study showed that in total, 80 suture lines were evaluated. SL/WL ratio of 4:1 as achieved in 95% using the Suture-TOOL and 30% using NDS. Suture time was 30% shorter using the Suture-TOOL compared to NDS.
Conclusions was that the Suture-TOOL seems to be a promising device to perform a speedy standardized high quality suture line for fascial closure.
Suture-TOOL is safe and easy to use
Fifteen surgeons who were specialists in surgery, urology, gynaecology, and surgical trainees participated. The Suture-TOOL was presented to the surgeons who read the instructions before starting the test. Each surgeon closed nine 15 cm-long incisions in a human body model: six with the suturing instrument and three with the NDS technique. Endpoints were SL/WL-ratio, closure time, number of stitches, learning curve, and glove puncture rate.
Results from the previous study was repeated in the human body model: adherence to SL/WL ratio of 4 was 98% for Suture-TOOL and 69% for NDS. Suture-TOOL suturing was 30% faster.
The conclusion of the study is that Suture-TOOL is a promising device for clinical use. It is safe, easy, and fast resulting in a high-quality suture line with a short learning curve and a high functionality ranking.
Further studies and next steps
A first in man clinical trial on patients undergoing colorectal surgery will be conducted and start Q4 2022. More information about our studies and clinical results, will be published in our newsletter and on our social media channels. Don’t forget to sign up and follow us on LinkedIn and Twitter.
- Gabriel Börner, Marcus Edelhamre, Peder Rogmark, Agneta Montgomery. Suture-TOOL: A suturing device for swift and standardized abdominal aponeurosis closure. Surgery in Practice and Science 11 (2022) 100137.
- Deerenberg E, Harlaar J, Steyerberg E et al (2015). Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet 26(386):1254–1260 5.
- Gabriel Börner, Agneta Montgomery. Suture-TOOL: A Mechanical Needle Driver for Standardized Wound Closure World J Surg (2020) 44:95–99.
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