1. Knots tying in robotic surgery
Marco ODERDA

2. Robotics: advantages Improved dexterity Seven degrees of freedom
3D vision
Smoothness of movements
Auto-control of the camera (zoom in and out)

3. Robotics: ergonomics Arms and shoulder must be relaxed
Always be aware of posture and instrument motion
Take care on the tip of the needle!

4. Robotics: needle position

5. Single knot suturing
Two stitches, each in opposite directions to one another, will finalize the single knot.

6. Single knot suturing

7. Continuous suturing
The final loop is ultimately used for the first knot made in the same way as in the single knot technique

8. Continuous suturing

9. Extracorporeal suturing
Pushed half knot and Weston knot
It can be useful especially in laparoscopy!

10. Extracorporeal suturing

11. Robotics: disadvantages
No tactile feedback!
Visual force feedback is used as a tactile feedback surrogate (visual color scales?)

12. Which suture materials?
Polyglactin (Vycril) vs polyester (Ethibond) vs polypropylene (Prolene)
The robotically tied knots were strongest with polypropylene and weakest with polyglactin! Monofilament suture stiffness often requires that the surgeons use a surgical clamp to provide extra leverage.