The Use of a New Articulating Suturing Device with a Curved Needle in Bariatric and Hernia Repair; A Surgeon’s Clinical Experience in 1500 cases.

Nicole Pecquex, MD¹, Gina Wilson, BSN, RN², Randall Wright, MD³. ¹St Elizabeths Medical Center, ²EndoEvolution,LLC, ³Wise Regional Hospital

Laparoscopic suturing and knot tying is well established as one of the most complex and time-consuming skills for a surgeon to master.  The consequences of under-developed laparoscopic suturing skills can lead to long surgery times and post-operative patient complications.  The objective of the Endo360 device is to simplify the learning curve of laparoscopic suturing for residents and experienced surgeons while improving the quality of suturing with a device that approximates tissue the way surgeons do in open procedures.

The Endo360 ° is a reusable suturing device which operates curved needles to replicate the wrist approximation of suturing manually. The curvature of the needle allows the surgeon to take up to an 8mm bite consistently.  The sharp tip enables placement of single interrupted stitches or a series of running stitches through tissue atraumatically.  The distal tip is wristed for optimal access in confined spaces.  The handle is a pistol-like grip for ease of operation. Two full squeezes of the handle rotate the needle 360 °. The needle is driven by a pawl in the needle track. The pawl moves in a 180 ° counter clockwise direction. Proficient knots can be tied, intracorporeally or extracorporeally.

The Endo360 device has been successfully utilized in over 5000 cases across the United States.  Surgeon KOLs report the device provides many clinical advantages in laparoscopy.  “Because it is intuitive to use, there’s a low learning curve. Anyone doing any type of laparoscopic procedure can get up to speed quickly.” Randy Wright, MD.  Some advantages are the accuracy and precision placement of the curved needle, and the ability to control the depth of the needle. “Squeezing the handle of the Endo360 ° device slightly advances the needle enough to see the tip as it passes through the tissue. And we can achieve a nice bite because of the device’s wide jaw, which allows us to control depth.” Scott Stowers, DO, FAMBS.   “The curve of the needle, its sharpness and linear suture arrangement, along with the precision of needle placement, gives me the confidence to suture through delicate tissues such as the anterior wall of the esophagus.” Randy Wright, MD.  “The Endo360° device speeds up my suturing time significantly. The ability to rotate and articulate with a curved needle, I can really get full thickness bites.” Nicole Pecquex, MD, FAMBS, Boston, MA.  “With the Endo360°, I can complete many different suturing techniques with one device; suture along the abdominal wall gaining full thickness bites, tie intracorporeally, and easily do a running stitch thru mesh, even trocar port closure efficiently.” Paresh Shah, MD.

The Endo360 device brings a new emerging technology to the operating room that simplifies the learning curve and improves the quality of laparoscopic suturing.  The Endo360 was designed to work the way surgeons traditionally suture.  Simple hand squeezes decrease wrist and forearm movement while giving surgeons superior precision and control of a curved needle.  As a result, less trauma to the tissue and a decreased potential for post-operative leaks and tissue dehiscence.