title: Development of a needle driver with multiple degrees of freedom for neonatal laparoscopic surgery.
abstract: OBJECTIVE
  The aims of this study were to develop a thin needle driver with multiple degrees of freedom and to evaluate its efficacy in multidirectional suturing compared with a conventional needle driver.
  
  
  METHODS
  The tip (15 mm) of the novel user-friendly needle driver (3.5 mm in diameter) has three degrees of freedom for grasping, rotation, and deflection. Six pediatric surgeons performed two kinds of suturing tasks in a dry box: three stitches in continuous suturing that were perpendicular or parallel to the insertion direction of the instrument, first using the novel instrument, then using a conventional instrument, and finally using the novel instrument again. The accuracy of insertion and exit compared with the target points and the procedure time were measured.
  
  
  RESULTS
  In the conventional and novel procedures the mean gaps from the insertion point to the target in perpendicular suturing were 0.8 mm and 0.7 mm, respectively; in parallel suturing they were 0.8 mm and 0.6 mm, respectively. The mean gaps from the exit point to the target in perpendicular suturing were 0.6 mm and 0.6 mm for conventional and novel procedures, respectively; in parallel suturing they were 0.6 mm and 0.8 mm, respectively. The procedure time for perpendicular suturing was 33 seconds and 64 seconds for conventional and novel procedures, respectively (P=.02); for parallel suturing it was 114 seconds and 91 seconds, respectively.
  
  
  CONCLUSIONS
  Our novel needle driver maintained accuracy of suturing; parallel suturing with the novel driver may be easier than with the conventional one.
authors.affiliation: Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan. i-tetsuya@umin.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishimaru
authors.forename: Shinya
authors.initials: S
authors.lastname: Takazawa
authors.forename: Hiroo
authors.initials: H
authors.lastname: Uchida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fujii
authors.forename: Kanako
authors.initials: K
authors.lastname: Harada
authors.forename: Naohiko
authors.initials: N
authors.lastname: Sugita
authors.forename: Mamoru
authors.initials: M
authors.lastname: Mitsuishi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
mesh_terms: D004867:Equipment Design; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D009339:Needles; D013536:Suture Techniques / Q000295:instrumentation*; D013997:Time Factors