Abstract
Abstract
Background:
Inadvertent suturing of drainage tubes during wound closure is an uncommon but troublesome complication following lumbar spine surgery. The conventional management requires reopening the incision to remove the entrapping suture, which constitutes an unplanned reoperation and carries additional risks. We developed a novel V-shaped intraluminal cutting knife fabricated from a Kirschner wire and evaluated its efficacy and safety in a rabbit model and a clinical case.
Methods:
Two blade configurations were manufactured from Kirschner wires: a V-shaped blade with bilateral blunt protrusions designed to capture and guide sutures into the cutting edge, and an A-shaped blade (control) without protrusions. Ten New Zealand white rabbits (weight 2.0–2.5 kg) underwent standardized laparotomy with placement and intentional suturing of two silicone drainage tubes in the paraspinal musculature. Each rabbit received one tube assigned to V-shaped knife extraction and the other to A-shaped knife extraction, with side allocation determined by a random number table (n = 10 attempts per device). The primary outcome was extraction success rate (complete removal within 10 minutes). The secondary outcome was extraction time. A 56-year-old patient who sustained inadvertent drainage tube suturing after L4–5 posterior lumbar interbody fusion was also treated with the V-shaped device.
Results:
The V-shaped knife achieved a 100% success rate (10/10) with a mean extraction time of 2.3 ± 0.4 minutes, whereas the A-shaped knife succeeded in 50% (5/10) with a mean extraction time of 6.8 ± 0.6 minutes. The difference in success rates was statistically significant (Fisher's exact test, P = 0.033), as was the difference in extraction times (independent-samples t-test, t = 19.72, P Conclusions:
The V-shaped intraluminal knife with bilateral protrusions provides a safe, rapid, and minimally invasive solution for removing inadvertently sutured drainage tubes after lumbar spine surgery, offering significantly superior performance compared with simple wedge-shaped blade designs. This low-cost, technically straightforward device has the potential to eliminate the need for reoperation in this clinical scenario.