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Text
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URL Address
<a href="http://doi.org/10.1089/end.2009.0573" target="_blank" rel="noreferrer noopener">http://doi.org/10.1089/end.2009.0573</a>
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Pages
1509-1513
Issue
9
Volume
24
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Title
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Diminished Suture Strength After Robotic Needle Driver Manipulation
Publisher
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Journal of Endourology
Date
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2010
2010-09
Subject
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outcomes; radical prostatectomy; Urology & Nephrology
Creator
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Ricchiuti D; Cerone J; Shie S; Jetley A; Noe D; Kovacik M
Description
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Robot-assisted minimally invasive surgery has become a routine surgical option for the treatment of prostate cancer. Despite its technical advancements, the da Vinci (R) Surgical System still lacks haptic feedback to the surgeon, resulting in a maximally applied compressive force by the robotic needle driver during every grasping maneuver. Without this perceptional sense of touch and grip control, repetitive robotic needle driver manipulation may unknowingly lead to irreparable damage to fine sutures used during delicate anastomotic repairs. For robotic prostatectomy, any such loss of integrity can potentially lead to premature breakdown of the urethrovesical anastomosis and urine extravasation, especially important for a less-than-perfectly fashioned anastomotic repair. Although it has already been established that overhandling of sutures using handheld laparoscopic instruments can lead to reduced suture strength, it has not been established to what extent this may occur after robotic surgical procedures. We present analytical data and analyses concerning the failure strength of fine sutures commonly used for urethrovesical anastomotic repair during robotic prostatectomy, after repetitive robotic needle driver manipulation. When compared with noncompromised monofilament suture controls, the average maximal failure force after repetitive robotic manipulation was significantly reduced by 35% (p<0.0001). Similarly, the average maximal failure force of braided sutures was significantly reduced after repetitive robotic manipulation by 3% (p=0.009). This work demonstrates that significant reductions in monofilament and braided suture strength integrity can occur after customary repetitive manipulation by robotic needle drivers in an ex vivo model, with further research warranted in the in vivo setting.
Identifier
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<a href="http://doi.org/10.1089/end.2009.0573" target="_blank" rel="noreferrer noopener">10.1089/end.2009.0573</a>
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Journal Article
2010
Cerone J
Jetley A
Journal Article
Journal of endourology
Kovacik M
Noe D
outcomes
radical prostatectomy
Ricchiuti D
Shie S
Urology & Nephrology