Automatic Uterine Incision closure device

Automatic Uterine Incision closure device

Girija S Mohanty , Aashima Arora, Vanita Suri
PGIMER, Chandigarh, India

Rationale: The incidence of lower segment cesarean section ranges from 20-to 50% in different countries. (1) There are non-uniformity in suturing the incised lower segment uterine edges as most of the LSCS was done by the newly learning obstetricians. Because of this, there is an increased incidence of placenta accreta syndrome in a future pregnancy, weak scar leading to increased risk of uterine rupture during subsequent pregnancy, adhesion formation and isthemocele formation/ (Niche). (2) Because of prolonged and nonsymmetrical approximation during suturing, there is more blood loss from uterine lower segment incised edges. Aim of any surgery is to restore the anatomy to near normal condition.

Novelty of the invention: LSCS is one of the main procedures in Obstetrics is the cesarean section, which is closed only by hand suturing with a needle holder. Due to the limitations of hand suturing method, a novel automatic handheld suturing machine was conceptualized and 3D designed and equipped with a needle-driving system, a thread control mechanism, and a linear mechanism, which is applicable in uterine incision by making continuous sutures, which will be symmetrically placed by the device . The main advantages of this machine are employing bio-compatible sutures from the tissue’s adaptation point of view and making a uniform suturing pattern, independent of the surgeon’s skill, thus offering greater strength than the hand-sutured specimen. Many studies have concluded that a more uniform suture will result in greater mechanical strength of the sutured tissue. This machine is designed to take a bite with an elongation rate of 5-10 mm/bite. From the mechanical strength point of view, the optimum pattern is fixed for this automatic suturing device that each bite will follow, h10 d10 ( h = distance of suture from the edge of the tissue = 10 mm, and d = distance between stitches = 10 mm). (3) This will ensure apposition of decidua to decidua , myometrium to myometrium ,preventing bulding out of the decidua to out side. Finally, the clamp used to hold the uterine margin during suturing will reduce the total amount of blood loss during surgery.

Keywords: LSCS, Automatic suturing device, Placenta accreta