Mastering Robotic Suturing: Tips and Tricks

INTRODUCTION: Robotic surgery offers many advantages including improved visualization, degrees of wrist articulation, ability for ease of suturing in multiple orientations, and maintaining surgeon ergonomics. These unique features along with a systematic approach can help flatten the robotic suturing learning curve and improve suturing efficiency. OBJECTIVE: The objectives of this video are to review the basic principles of robotic suturing, to discuss key tips and tricks for robotic suturing, and to demonstrate the application of these techniques in various gynecologic procedures. METHODS: Educational video highlighting tips and tricks for efficient robotic suturing. RESULTS: We review key tips and tricks to maximize efficiency for robotic suturing including needle management, running suture, knot tying, and use of the 4th arm. We highlight various techniques for suture management, such as hand-over-hand, pulley maneuver, needle hook, and needle trapping. We also review the use of these techniques in a vaginal cuff closure, myomectomy, and sacrocolpopexy. CONCLUSIONS: Mastering the basic techniques reviewed in this video will allow learners at all stages to become safe and efficient robotic surgeons.