Just about every major operation on the chest or abdomen requires surgeons to cut through the fascia, which is a layer of muscle located immediately beneath the skin. Closing these wounds can be very difficult – sewing up an incision in the fascial layer has been likened to trying to push a needle through shoe leather. If proper care isn’t taken, however, potentially lethal complications can result. Now, a team of undergraduate students from Johns Hopkins University have created a device that should make the procedure easier and safer.
Known as FastStitch, the one-use disposable tool is made mainly from ABS plastic, and is described as being a cross between pliers and a hole punch. It was initially created as a biomedical engineering course assignment.
To use it, the fascial layer is placed between its upper and lower arms. When the user then squeezes it shut, an integrated spring-loaded clamp drives the suturing needle from one arm, through the muscle layer, and into the other arm. This process can be repeated down the length of the incision, with the needle being transferred back and forth between the arms, pulling the surgical thread through the fascia as it goes.
When the same process is performed purely by hand, there is a risk that the needle could give suddenly and slip through to puncture the bowel. This could lead to a sepsis infection which would require considerable medical attention, and could even result in death.
FastStitch also has a built-in visual guide, to help surgeons place their stitches an even one centimeter apart. This should help to avoid complications such as herniations, in which intestinal tissue ends up protruding through incisions that haven’t been closed properly.
The students have formed a spin-off company, Archon Medical Technologies, to develop the device further. Animal tests are underway, with testing on human cadavers planned to take place later this year.