Eduardo Sánchez-de-Badajoz1*, José Manuel Martínez-Moreno1, José María Lage-Sánchez1, Pilar Sánchez-Gallegos1, Irene Rivas-Blanco2 and Víctor Fernando Muñoz-Martínez2
1Teaching Unit of Urology, School of Medicine, University of Malaga, Spain
2Department of System Engineering and Automatics, University of Malaga, Spain
Introduction: Although mechanical sutures represented a before and an after in digestive surgery, their use in urology is greatly limited by the risk of stone disease and chronic infection. Accordingly, in laparoscopic cystectomy, the intestinal time is still usually done by hand extra-corporeally. Even using a robot, sutures are still slow and imperfect, varying in tension, symmetry and separation between stitches. It is therefore expected that, little by little, they will become independent from human control. Methods: We used a small sewing machine available on the market to undertake an experimental study in pigs. In one group of animals we separated the bladder into two valves which we then sewed together. In the other group we performed a cystoplasty with the cecum. Results: We determined that these sewing machines can be used with living tissue with no need to manufacture a complicated and expensive prototype. Although we experienced a series of technical mishaps, we were able to perform the sutures successfully, achieving complete tightness. The operative times were good despite testing a new instrument for surgery. Conclusion: Sewing machines can be used with biocompatible material. Surgical robots, although in existence for over 20 years, are still unable to automate the suture process, whereas sewing machines are more precise, predictable and can even be considered a small robot. Nevertheless, these machines still require great modifications before they can give guaranteed sutures in living tissue.
Sewing machine; Mechanical suture; Cystoplasty; Robotic suture
Sánchez-de-Badajoz E, Martínez- Moreno J, Lage-Sánchez J, Sánchez-Gallegos P, Rivas-Blanco I, Muñoz-Martínez V. Sewing Machine in Urologic Surgery. Clin Surg. 2021; 6: 3256..