A randomized comparison of conventional vs articulating laparoscopic needle-drivers for performing standardized suturing tasks by laparoscopy-naive subjects.
OBJECTIVE
To compare the efficacy of conventional and articulating laparoscopic needle-drivers for performing standardized laparoscopic tasks by medical students with no previous surgical experience.


METHODS
Twenty medical students with no surgical experience were randomly assigned to two equal groups, one using a conventional laparoscopic needle-holder (Karl Storz, Tuttlingen, Germany) and the other using a first-generation articulating laparoscopic needle-holder (Cambridge Endo, Framingham, MA, USA). Each student performed a series of four standardized laparoscopic tasks, during which speed and accuracy were assessed. The tasks tested needle passage through rings (1), an oblique running suture model (2), a urethrovesical anastomosis model (3) and a model simulating renal parenchymal reconstruction following partial nephrectomy (4).


RESULTS
Tasks 1 and 3 were completed significantly more quickly by those using the conventional instruments (P < 0.05), but there was no statistically significant difference for task 2 and 4 (P > 0.05). Those using conventional instruments were significantly more accurate in all of the tasks than those using the articulated instruments (P < 0.05).


CONCLUSIONS
The conventional laparoscopic needle-driver allowed laparoscopy-naive medical students to complete a series of standardized suturing tasks more rapidly and accurately than with the novel articulating needle-driver. Laparoscopic suturing with first-generation articulating needle-drivers might be more difficult to learn, secondary to the complexity of physical manoeuvres required for their use.
Tuncel
Altug
A
Department of Urology, University of Texas South-western Medical Center, Dallas, Texas 75390-9110, USA.
Lucas
Steven
S
Bensalah
Karim
K
Zeltser
Ilia S
IS
Jenkins
Adam
A
Saeedi
Osamah
O
Park
Sangtae
S
Cadeddu
Jeffrey A
JA
D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D009339:Needles; D013337:Students, Medical; D013536:Suture Techniques / Q000295:instrumentation* / Q000592:standards; D013520:Urologic Surgical Procedures / Q000295:instrumentation* / Q000592:standards