A robotic suture‐passing device for possible use in SILS and NOTES

BACKGROUND: Natural orifice transluminal endoscopic (NOTES) and single incisional laparoscopic surgeries (SILS) have been gaining importance over the last two decades. Due to improper instrumentation, small workspace and the imperceptibility of body structures, suturing and knot-tying are difficult to perform in both. METHODS: An intracorporeal suture-passing device with two manipulator arms is proposed that automatically passes the suture around ducts of up to 7 mm diameter, without additional manipulation of any other surgical instrument, and it can be deployed through a trocar of 3 mm inner diameter. RESULTS: The working mechanism was validated by 15 trials, where passing the suture around a phantom tube was tested, and the operating time measured as (34.55 ± 4.55) seconds. CONCLUSIONS: Suturing and knotting in SILS and NOTES are currently challenging techniques, but the proposed device enables the suture to be automatically passed around ducts. It is expected that clinical evaluations of future prototypes will further confirm the efficacy of the device.