🔍 Key Findings

• Standard laparoscopic instrumentation (SLI) was faster: median suture-line time was 6 min (5–10) with SLI versus 8 min (6–11) with the articulating needle driver (ALI); ALI added a modeled mean 1.9 min per suture line (p < .0001).
• ALI increased surgeon mental workload: NASA-TLX scores were significantly higher with ALI for mental demand, perceived performance, effort, and frustration.
• Objective technical performance favored SLI: mean global rating checklist scores were 17.7 for SLI versus 15.24 for ALI (p < .0001), although inter-rater agreement was only moderate-to-low (r = .36).
• No ergonomic advantage was demonstrated: shoulder, neck, back, wrist, forearm, and hand scores did not differ significantly between ALI and SLI.
• Both instruments successfully permitted TLG: all 17 client-owned dogs completed the procedure without conversion, supporting the feasibility of ALI despite inferior measured performance.
• Adverse events were uncommon and unrelated to ALI: two grade 2 intraoperative events occurred because of SLI device failure requiring replacement, and no postoperative complications were reported.
• A learning-curve effect may explain ALI performance: the surgeon was proficient with SLI but had no prior clinical ALI experience before the trial; the authors caution against interpreting the initial performance disadvantage as definitive evidence against ALI.
• Clinical benefit may depend on the procedure: investigators subjectively appreciated ALI's increased dexterity but noted reduced perceived needle-grasping strength; the device may prove more advantageous in difficult suturing orientations than routine TLG.