title: Endosew: new device for laparoscopic running sutures.
abstract: OBJECTIVE
  In 2002, the first completely laparoscopic cystectomy and orthotopic ileal neobladder procedure was reported to take more than 10 hours, with the most time-consuming portion being suturing. Therefore, to improve the quality and reduce the time to place running sutures, we developed a new sewing device for laparoscopic use.
  
  
  METHODS
  We compared running sutures made by hand with those made by machine in the ilea of six pigs. The tightness of the closures was examined and the suturing time recorded. Two animals each were sacrificed after 3, 6, and 9 days, and then the explanted ilea were examined at both the macroscopic and microscopic levels.
  
  
  RESULTS
  No animal died during the course of the experiment and no leaks were found postoperatively. Moreover, no significant differences were seen on macroscopic or microscopic examination in the quality of the two sets of sutures. The time taken to place 1 cm of running suture, including initial preparation, was 7.2 and 3 minutes for hand and machine suturing, respectively. The hand sutures were always initially tight, whereas those placed by machine required adjustment to stop leaks on four occasions.
  
  
  CONCLUSIONS
  Using the Endosew device reduces the time needed to place running sutures by 2.4-fold. The quality of the hand- and machine-made sutures was nearly identical at both the macroscopic and microscopic level. Thus, the functionality of this new sewing device is more than satisfactory, and the amount of time saved by using it far outweighs the need for occasional adjustments to stop suture leakage.
authors.affiliation: Urological Clinic, University Clinic, Rheinisch-Westfälische Technical University Aachen, Aachen, Germany. BBrehmer@ukaachen.de
authors.forename: Bernhard
authors.initials: B
authors.lastname: Brehmer
authors.forename: Clemens
authors.initials: C
authors.lastname: Moll
authors.forename: Antonios
authors.initials: A
authors.lastname: Makris
authors.forename: Ruth
authors.initials: R
authors.lastname: Kirschner-Hermanns
authors.forename: Ruth
authors.initials: R
authors.lastname: Knüchel
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jakse
mesh_terms: D000818:Animals; D004867:Equipment Design; D005260:Female; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D013536:Suture Techniques / Q000295:instrumentation*; D013552:Swine; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*