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Automated devices may replace traditional medical stitching, predict inventors

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Operating theatres may soon with two suturing devices that could provide a new alternative to hand stitching, according to those behind the new technology.

The medical research company Sutrue devised the machine stitching tools, one of which is a handheld device and the other a larger endoscopic robot.

“You get to delegate it to someone – or something – that doesn’t need medical school”

Richard Trimlett

The devices, which were demonstrated at an event this week, produce rows of sutures, tie knots and sew around corners through tissues as they stretch and twist unpredictably.

Robots have aided surgeons since the PUMA 560 was used during a biopsy in 1985, but needle-and-thread suture techniques have largely not changed since the time of Ancient Egypt.

The Sutrue devices began as an idea inspired by a TV programme about robotic surgery that inventor Alex Berry watched 10 years ago.

After five years of developing the mechanism, five years of refining, 38 prototypes, 1,500 tested parts and over 15,000 hours of design work, the tools passed final testing this year.

Mr Berry, who is also managing director of Sutrue, said the machines were an asset during painstaking, error-prone sutures in hard-to-reach areas or through long stretches of tissue.

“It needs the final step. It needs to find someone who can commercialise it”

Richard Trimlett

He said his suturing devices cut human error by making the process simpler and more accurate with its deft, even strokes. It also reduced reliance on the ability, training and alertness of a practitioner.

Mr Berry said the devices can speed up some of surgery’s most time-consuming work, slashing the 25 seconds per stitch experienced surgeons require for sutures to a mere one-third of a second per stitch.

Medical technology consulting engineer Stephen Squire said the key was the mechanism behind the device and its ability to pass a needle through tissue and then recapture it – a function that had not been developed before.

Meanwhile, cardiothoracic surgeon Mr Richard Trimlett said the devices offered a way for less experience healthcare workers to stitch up large wounds during cardiac, thoracic, cranial and gastrointestinal surgery.

“You get to delegate it to someone – or something – that doesn’t need medical school and six years of training but can still do the job well,” he said.

John Pepper, cardiothoracic surgery professor at the National Heart and Lung Institute, noted that inexperienced healthcare professionals could unwittingly cause tissue damage and scarring while suturing, and that the Sutrue devices would reduce that risk.

But Mr Trimlett, who works at the Royal Brompton and Harefield NHS Trust, highlighted that the devices still had a long way to go before they become hospital staples.

The research team has yet to test the suture tools on patients and have not yet approached GPs and nurses about the possibility of using the devices without a surgeon’s training.

Sutrue

Suture device

Source: Christine Fernando

Handheld suture device

He also said the endoscopic robot had limitations such as constrained movement and being difficult to feel what you are doing.

But he said the functioning mechanism was a breakthrough and he remained confident the device can become an operating room workhorse after a few more years of edits.

“It needs the final step,” he said. “It needs to find someone who can commercialise it, so that I can take it off the shelf and use it.”

Funded by investors including the NHS, Sutrue’s devices stand to save the NHS £10.7m a year, according to a study by York Health Economics Consortium.

Mr Trimlett said they also had the potential to reduce needle stick injuries among healthcare practitioners, thereby curbing the risk for infections such as HIV and hepatitis B.

In addition. the endoscopic robot may reduce the need for open operations by expanding the ability to stitch tissue together internally without “opening up” patients, said Mr Trimlett.

“It’s true to say that the majority of operations we’re doing today are still open and that’s not because the patient wants them open, it’s because of the limitations of the technology,” he said.

He added: “There are many improvements to technology that we need to get to the point where we can do everything as a keyhole operation, and I see this as one of them.”

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