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Tensile Strength of Surgical Knots Performed with the da Vinci Surgical Robot.

Reynisson, Petur LU ; Shokri, Ebi; Bendahl, Pär-Ola LU and Persson, Jan LU (2010) In Journal of Minimally Invasive Gynecology Apr 7. p.365-370
Abstract
The objective of this study was to estimate the tensile strength of surgical knots made using the da Vinci robot. Four different types of flat square knots (strand-to-strand 4 throw, strand-to-strand 6 throw, loop-to-strand 4 throw, and loop-to-strand 6 throw) were made using the da Vinci-S system by 4 different surgeons, all experienced with the system. For the knots, we used braided polyglactin 910 (Vicryl 2-0). Hand-tied, flat, square, 4-throw strand-to-strand knots were used as reference. The tensile strength was measured for all knots using the Instron 5566 system calibrated to an accuracy of +/-.5% at 4 to 10 newtons (N) and +/-.4% at greater than 10 N. Compared with reference knots, only 1 of 4 surgeons could make knots as equally... (More)
The objective of this study was to estimate the tensile strength of surgical knots made using the da Vinci robot. Four different types of flat square knots (strand-to-strand 4 throw, strand-to-strand 6 throw, loop-to-strand 4 throw, and loop-to-strand 6 throw) were made using the da Vinci-S system by 4 different surgeons, all experienced with the system. For the knots, we used braided polyglactin 910 (Vicryl 2-0). Hand-tied, flat, square, 4-throw strand-to-strand knots were used as reference. The tensile strength was measured for all knots using the Instron 5566 system calibrated to an accuracy of +/-.5% at 4 to 10 newtons (N) and +/-.4% at greater than 10 N. Compared with reference knots, only 1 of 4 surgeons could make knots as equally strong with the robot. For all surgeons, strand-to-strand knots had a significantly higher tensile strength than loop-to-strand knots when made with the robot. Adding 2 throws to the knot did not increase the knots strength in the robot. It is possible to make equally strong surgical knots with the da Vinci robot as by hand; however, despite previous experience with the robot, only 1 of 4 surgeons managed to do so. Adding 2 throws to R4SS and R4LS knots did not increase the tensile strength significantly for any of the 4 surgeons. It is important to train and tie knots using the da Vinci system with the same care as by hand and to be aware of possible differences in knot-tying technique with the robot and manually. With the robot, strand-to-strand knots were stronger than loop-to-strand knots, and should be preferred. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Minimally Invasive Gynecology
volume
Apr 7
pages
365 - 370
publisher
Elsevier
external identifiers
  • wos:000277788200017
  • pmid:20227925
  • scopus:77953285507
ISSN
1553-4669
DOI
10.1016/j.jmig.2010.01.005
language
English
LU publication?
yes
id
92720dd1-7ee9-4e48-8c6d-86967cad9604 (old id 1582209)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20227925?dopt=Abstract
date added to LUP
2010-04-07 17:01:24
date last changed
2018-05-29 11:50:12
@article{92720dd1-7ee9-4e48-8c6d-86967cad9604,
  abstract     = {The objective of this study was to estimate the tensile strength of surgical knots made using the da Vinci robot. Four different types of flat square knots (strand-to-strand 4 throw, strand-to-strand 6 throw, loop-to-strand 4 throw, and loop-to-strand 6 throw) were made using the da Vinci-S system by 4 different surgeons, all experienced with the system. For the knots, we used braided polyglactin 910 (Vicryl 2-0). Hand-tied, flat, square, 4-throw strand-to-strand knots were used as reference. The tensile strength was measured for all knots using the Instron 5566 system calibrated to an accuracy of +/-.5% at 4 to 10 newtons (N) and +/-.4% at greater than 10 N. Compared with reference knots, only 1 of 4 surgeons could make knots as equally strong with the robot. For all surgeons, strand-to-strand knots had a significantly higher tensile strength than loop-to-strand knots when made with the robot. Adding 2 throws to the knot did not increase the knots strength in the robot. It is possible to make equally strong surgical knots with the da Vinci robot as by hand; however, despite previous experience with the robot, only 1 of 4 surgeons managed to do so. Adding 2 throws to R4SS and R4LS knots did not increase the tensile strength significantly for any of the 4 surgeons. It is important to train and tie knots using the da Vinci system with the same care as by hand and to be aware of possible differences in knot-tying technique with the robot and manually. With the robot, strand-to-strand knots were stronger than loop-to-strand knots, and should be preferred.},
  author       = {Reynisson, Petur and Shokri, Ebi and Bendahl, Pär-Ola and Persson, Jan},
  issn         = {1553-4669},
  language     = {eng},
  pages        = {365--370},
  publisher    = {Elsevier},
  series       = {Journal of Minimally Invasive Gynecology},
  title        = {Tensile Strength of Surgical Knots Performed with the da Vinci Surgical Robot.},
  url          = {http://dx.doi.org/10.1016/j.jmig.2010.01.005},
  volume       = {Apr 7},
  year         = {2010},
}