Why is circular suturing so difficult?

Chloe Topolski, Cédric Dumas, Jérôme Rigaud, Caroline G L Cao

Research output: Chapter in Book/Report/Conference proceedingConference contribution


Suturing is a basic surgical skill that is requires much training to achieve competency. Circular suturing is even more challenging, especially in minimally invasive surgery. In a radical prostatectomy procedure, circular suturing is performed to reconnect the bladder and urethra after the prostate has been removed. Task analysis of linear suturing and circular suturing, each using the laparoscopic and robot-assisted approaches, was performed and validated. Results revealed that circular suturing involves more motoric and perceptual constraints than linear suturing, requiring depth perception for proper alignment of two differently sized circular sutures. Robotic surgical systems such as the da Vinci Surgical System can reduce some of these constraints by providing a stereoscopic view of the circular structures and increasing the manipulability of the needle and tissue. These findings will inform the design of training and assessment of performance, as well as assistive tools to enhance the performance of circular suturing.
Original languageEnglish (US)
Title of host publicationHuman Factors and Ergonomics Society Europe Annual Meeting 2019
Place of PublicationNantes, France
StatePublished - Oct 2019
Externally publishedYes


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