Making Traditional Laparoscopic Suturing More Precise:Establishment and Promotion of the Laparoscopic 360° Suturing Theory
JU Zhenghua
CHEN Shushang
ZHU Qingguo
MA Xin
LI Hongzhao
ZHENG Tao
FU Bin
XU Kai
AI Xing
ZHANG Guoxi
WANG Chao
WANG Baojun
SHI Taoping
YAN Yongji
WU Zhun
LIN Zhitao
WENG Shaokun
Yin Yuming
ZHAN Bin
Abstract：Objective To address the issues of insufficient precision and high difficulty in laparoscopic suturing,this study aimed to establish and promote the 360° suturing theory,which is based on 360° needle holding to ensure precise suturing.Methods The 360° suturing theory was proposed,consisting of four core frameworks:the principle of simplified needle adjustment,the principle of vertical needle insertion,the horizontal 360° suturing method,and the simplified vertical suturing method.Relevant derivative issues of this theory were also elaborated.A 360° suturing training module was devel-oped,and a 360° suturing training program—comprising three parts:theoretical explanation,simulation box practice and testing,and telephone follow-up—was implemented to help surgeons improve their suturing skills.This program was used to verify the effectiveness and ease of promotion of the 360° suturing theory.Results From April 2023 to April 2024,223 sur-geons from 6 medical centers in China participated in the 360° suturing training program.The surgeons were divided into groups based on their years of laparoscopic surgery experience:Group A(56 surgeons),Group B(84 surgeons),Group C(63 surgeons),and Group D(20 surgeons),with a median laparoscopic surgery experience of 11.9 years.After training,81 surgeons(36.3%)completed 12 stitches of 360° suturing within 6 minutes,87 surgeons(39.0%)completed it within 12 min-utes,and 55 surgeons(24.7%)completed it within 24 minutes.Eighty surgeons were followed up by telephone.Regarding whether the training helped improve laparoscopic suturing skills,reduced the rate of conversion to open surgery and robotic surgery,ensured precise suturing,and whether the training model was easy to replicate,all 80 surgeons(100%)expressed satisfaction;78 surgeons(97.5%)considered the theory easy to understand;and 62 surgeons(77.5%)believed the theory could be easily applied in clinical suturing.Conclusions The 360° suturing theory is simple and feasible.It can help sur-geons perform precise laparoscopic suturing and reduce the proportion of conversions to open surgery and robotic surgery.
Keywords：360° suturinglaparoscopic trainingforward needlingreverse needlingpricking needlinghooking needling
Publication Date：2025-10-28
Online Publishing Date：2026-01-15(First online date of this platform, not the publication date of the document)
Pages：7( 289-295 )