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RD180 Suturing Device

The RD180 (LSI Solutions, Victor, NY) is a minimally invasive suturing device with a lever-operated, normally retracted needle. Its 5-mm version has been described for endoscopic transurethral incision with transverse mucosal realignment (TUITMR) through the JNW UrTrac sheath.[1][2]

Design​

  • The 5-mm version has a 33-cm shaft; 10-mm and SP variants exist. Match the actual model, port or sheath, and current IFU.[1]
  • Use the specified RD QUICK LOAD suture, such as compatible 2-0 MONOGLIDE, rather than an assumed interchangeable suture.[1]
  • One squeeze–release passes the needle; after clearing tissue, a second squeeze–release remotely rearms it for a subsequent bite. The 5-mm IFU permits up to 12 bites per quick load and 12 quick loads per device.[1]
  • The needle retracts when the lever is not squeezed, but is exposed during actuation. Avoid squeezing against dense tissue or a misaligned device; inspect function and account for any needle damage.[1]

Use in TUITMR Endoscopic Urethroplasty​

During the procedure:

  1. JNW UrTrac sheath provides endoscopic access to the bladder neck or VUA
  2. The model-compatible RD180 and quick load are passed through the UrTrac in the described technique
  3. Under endoscopic visualization, take bites at the healthy mucosa–resection-bed junction, minimizing incorporation of the scar bed rather than deliberately sewing through dense scar[2]
  4. Squeeze–release passes the needle; clear tissue and rearm as directed in the model's IFU before another bite[1]. In the described TUITMR technique, route the suture over the groove behind the device head on sheath entry and maintain the bite orientation during rearming to avoid suture shearing.[2]
  5. Place sutures to realign healthy mucosa transversely across the treated segment[2]
  6. Sutures are secured with the Ti-Knot fastener

Practical Considerations​

  • A normally retracted needle can simplify handling in a restricted channel; passage still requires visualization, appropriate tissue capture, and attention to sharps during actuation. Comparative urethral safety or success superiority has not been established by the cited technical report.
  • Use only compatible quick loads; do not reuse or resterilize the sterile single-use device. The IFU warns that exposed suture or retained foreign material in urine may form calculi.[1]
  • LSI's September 17, 2026 product-revision notice says the 5-mm RD180 (SKU 021100) is being revised as RD360 Plus with a mode indicator ("Pick Up" versus "Rearm") and a SPINI function that rotates the device into six positions. Confirm the supplied model and its own IFU before use.[3]

Other Applications​

The family is marketed for soft-tissue approximation in minimally invasive surgery, including gynecologic, colorectal, and general-surgical applications; case-specific indications and compatible suture differ by model.[1] A separate posterior-substitution-urethroplasty technique also describes RD180 as an alternative for very deep proximal apical sutures.[4]

References​

1. LSI Solutions. RD180 product and 5-mm RD180 technical guide, P/N 022227F (2025); 5-mm IFU PDF.

2. Dash ME, Warner JN. Detailed surgical technique for endoscopic urethroplasty in the treatment of anastomotic stenosis and bladder neck contracture. Transl Androl Urol. 2025;14(11):3745–3756.

3. LSI Solutions. 5-mm RD/RD180 product revision customer notification. September 17, 2026.

4. Kaldany A, et al. Substitution urethroplasty for posterior urethral stenosis. Transl Androl Urol. 2025;14(12):3962–3974.

See also: JNW UrTrac Sheath, Ti-Knot Fastener, Bladder Neck Contracture, Vesicourethral Anastomotic Stenosis.