Laser Suturing Coming Soon to the OR

A new minimally invasive tool that closes wounds using a laser takes its inspiration from a laser welding process developed for plastics.

Although more and more surgeries are being carried out in a minimally invasive manner, the suturing of wounds can still be a challenge. Very often, piercing the tissue and tying the knots is difficult because the surgeons must perform surgeries in very tight quarters.

Unlike when sewing textiles, a knot must be made after every stitch, which is an exacting process that stresses the patient and can cause a number of complications: If the suture is too tight, there is the danger of a minor hemorrhage. In addition, the suture material can cut into the tissue and strangulate vessels, which may cause the tissue to die. On the other hand, if the suture is too loose, there may be bleeding at the edges of the wound.

Currently, setting the correct suture tension depends on the experience of the surgeon, who must subjectively estimate the optimum tension for each scenario. The surgeon does not have access to a reproducible, standardized setting.

Researchers at Fraunhofer Institute for Production Technology in Aachen have developed a semiautomatic process that enables a surgeon to connect the suture material with a previously set, predefined tension. Not only does it shorten the suturing process with respect to time, it also hastens the healing of the wound. The patient can then recover more quickly.

“With our new device, the edges of the wound can be joined quickly and safely, since it automatically ensures the optimum tension for the suture. The surgeon no longer has to deal with that. In the future, the difficult task of knotting the ends of the suture material will no longer be necessary, since they simply will be welded with the laser,” said Adrian Schütte, a scientist at the institute.

Schütte and his team have already successfully carried out the suturing process during tests in the laboratory.

“We were able to achieve the best results with a suture tension of 0 to 5 N and a lasing time of 0.1 s,” Schütte said.

The preclinical studies are slated to start in the course of this year at Aachen University Hospital. To begin with, the suturing instrument will be used for minimally invasive surgeries in the abdominal area. Schütte believes that it also can be adapted to keyhole surgeries of the heart. The institute researchers will display a prototype of the suturing instrument at the Medtec Europe Fair in Stuttgart from March 22 to 24.

For more information, visit: www.fraunhofer.de/en