How Covidien's Endo Stitch Cuts Operating Time and Costs

This new automated suturing device was able to cut down time spent in the operating room by roughly 40 minutes in one recent study.

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In a recent study, the Endo Stitch automated suturing device from Covidien was shown to lower mean hospital costs and operating room (OR) time during total laparoscopic hysterectomies treating benign conditions. In the study, the device reduced overall hospitalization costs by approximately $1,800 and cut OR time by roughly 40 minutes, on average, when compared to those same procedures performed with robotic assistance.

To get some perspective on the automated suturing device for laparoscopic surgery, Medgadget spoke with Stuart Hart, MD, FACOG, FACS, co-director of the University of South Florida Center for the Advancement of Minimally Invasive Pelvic Surgery, who has used the device for years and helped present the study results at the American Association of Gynecologic Laparoscopists 40th Global Congress of Minimally Invasive Gynecology in late November 2011.

How did the device make such dramatic time savings possible in this study? Also, could you explain what the device is like in terms of usability?

Laparoscopic suturing is a very difficult skill to obtain. This is partly because it is almost like you are operating with stilts. In open surgery, we are used to having a needle driver and we are holding the needle very closely with the needle driver close to where our hands are. Whereas in laparoscopic surgery, we have these long instruments. One of the big challenges is driving needles through tissue from the longer distance.

The other big issue is, in traditional laparoscopic surgery, the surgeon is looking at a two-dimensional screen while operating in three dimensions.

Basically, the [Endo Stitch] device automates the process of suturing. Instead of having to go through this steep learning curve of learning laparoscopic suturing, this extremely simple device allows you to suture with very little skill needed and there is little training involved. It's not much more involved than any laparoscopic instrument we typically use.

Just the ease of use of the device makes such impressive time savings possible. It allows you to very easily drive sutures through tissue without having to learn those advanced skills. When you automate the process, suddenly, that time goes down significantly. It just simplifies the whole process by automating it through the device. And it really adds significant time savings.

Doctors these days are forced to do more with less, thanks to a shortage of MDs and growing pressure to control costs in medicine. How do you think the Endo Stitch addresses these trends?


I think it is a really interesting question because cost containment is becoming one of the biggest issues in medicine. In this study, we looked at two things: We compared [the Endo Stitch] to robotic surgery and to traditional laparoscopic hysterectomies.

One of the challenges, as a physician who teaches courses in laparoscopic hysterectomies, is that the majority of hysterectomies, approximately 60-65 percent of them, are still being done through big open incisions. This is amazing because we have been doing them that way for more than 100 years and you would think that we would advance to a newer technology. But partly the reason that it is still being done open is the challenge of developing the laparoscopic skills.

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