Development of a novel successive suturing instrument for an endoscope using beads and a side suction cap

The large number of patients who suffer from diseases such as gastritis, obesity, and chronic gastro-esophageal reflux disease has made the development of a new suture device using an endoscope instrument channel an important priority. This paper deals with a novel design of an endoscopic instrument that facilitates suture operations on the stomach and esophagus. Unlike a laparoscope, it is very difficult to transfer forces and moments to the end of a gastrointestinal endoscope from the outside handle dues to its extreme flexibility. The only feasible forces are pushing and pulling using wires and tubes. This new design requires only the push-pull action from the outside handle to complete suture operations. Furthermore, several stitches can be performed with a single endoscope insertion. This new endoscope suturing methodology thus significantly reduces the time for surgical operations and the pain that patients experience. The feasibility of the instrument was demonstrated through in vitro and in vivo animal experiments.