Laparoscopic suturing and knot tying: a comparison of standard techniques to a mechanical assist device.

BACKGROUND: Suturing and knot tying are basic skills for surgeons. Performing these tasks laparoscopically can be a tedious, time-consuming endeavor associated with much frustration. We evaluated a mechanically assisted suture and pretied knot device (Quik-Stitch) for performing the basic tasks of suturing and knot tying. METHODS: We performed a time study using 1) intracorporeal suturing and knot tying, 2) intracorporeal suturing and extracorporeal knot tying, and 3) a mechanically assisted suture and pretied knot device (Quik-Stitch). From September 2000 through March 2001, time trials were conducted using each of the different techniques. Three attending surgeons, one with much experience and 2 with less experience, and 2 chief residents, with the least experience, participated in the study. RESULTS: For the experienced surgeon, the average times for intracorporeal knot tying, extracorporeal knot tying, and knot tying with Quik-Stitch were 97.3, 103.9, and 67.7 seconds, respectively. For the less experienced surgeons, the times were 237.2, 224.3, and 92.5 seconds, respectively. For the least experienced group, the times were 265.3, 263.0, and 128.7 seconds, respectively. CONCLUSIONS: The mechanically assisted suture device and pretied knot (Quik-Stitch by PARE Surgical, Inc, Englewood, CO, USA) provides significant time-saving to surgeons regardless of experience and thus reduces operating room costs. Less experienced surgeons and surgeons in training benefited the most by the use of this device.