A Novel Robotic Suturing System for Flexible Endoscopic Surgery

Perforations in flexible endoscopy are life-threatening. Defect closure or suturing in flexible endoscopy has long been a critical challenge due to the confined space of the access routes and surgical sites, high dexterity and force demands of suturing tasks, as well as critical size and strength requirements of wound closure. This paper introduces a novel robotic suturing system for flexible endoscopic surgery. This system features a flexible, through-the-scope, five-degree-of-freedom robotic suturing instrument. This instrument allows the surgeon to endoscopically manipulate a needle via a master console to create running stitches and knots in flexible endoscopy, which is not possible with existing devices. Successful ex-vivo trials were conducted inside porcine colons to show how surgical stitches and knots can be endoscopically created and secured in a completely new way. This new technology will change the way how surgeons close defects or perforations in flexible endoscopic surgery.