The Art of Suturing 

By Rodrigo Fernandes (Author), Armando Romeo (Author), Arnaud Wattiez (Author)  

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A definitive guide to laparoscopic suturing—where technique meets precision. 

This book delivers a practical, evidence-based approach to needle and suture selection in minimally invasive surgery, bridging fundamental principles with advanced laparoscopic and robotic techniques. Through clear explanations, high-quality surgical imagery, and step-by-step insights, it explores monofilament, multifilament, and barbed sutures, their biomechanical properties, tensile strength, absorption profiles, and real-world indications. 

Designed for surgeons at all stages of training, this work goes beyond “how to suture” to explain why each choice matters—transforming suturing from a technical task into a refined surgical skill. 

Why this book?

Suturing is one of the most fundamental yet underappreciated skills in surgery. Despite its central role in every procedure, there is surprisingly little structured guidance tailored specifically to the laparoscopic and robotic environment. I wanted to create a resource that not only teaches technique but explains the reasoning behind every choice — from needle geometry to suture biomechanics — so that surgeons can make truly informed decisions in the operating room.

What inspired it?

Years of teaching in Brazil and abroad and operating in minimally invasive gynecologic surgery made it clear that many trainees — and even experienced surgeons — rely on habit and evidence when selecting sutures and needles. That gap between practice and understanding was the driving force behind this project.

Who will benefit?

This book is designed for surgeons at all stages — residents building their foundation, fellows refining their technique, and experienced surgeons looking to deepen their understanding. It is also a valuable reference for surgical educators.

About the Co-Authors:

I am fortunate to have collaborated with two exceptional individuals whose contributions were indispensable to this work.

Prof. Arnaud Wattiez is a true icon and pioneer of minimally invasive gynecologic surgery. Professor of Obstetrics and Gynecology at the University of Strasbourg, Head of the Gynecology Department at Latifa Women and Children Hospital in Dubai, Chairman of the European Academy of Gynaecological Surgery, and past President of the European Society for Gynaecological Endoscopy, Prof. Wattiez has spent decades shaping the field — developing landmark techniques in endometriosis, pelvic organ prolapse, and gynecological oncology, and mentoring generations of surgeons worldwide through IRCAD and the MIS Academy. His vision and mastery elevate everything he touches, and this book is no exception.

Prof. Armando Romeo brings a perspective that is truly one of a kind. An industrial engineer — from the Politecnico di Milano — he dedicated his career to the science and pedagogy of laparoscopic suturing. As Education & Training Director for Latin America at Karl Storz, Invited Professor at Santa Casa University of São Paulo, and creator of the globally recognized “Gladiator Rule” technique, Armando has directed over 2,000 suturing courses at universities and congresses around the world. His engineering mindset transformed suturing from an intuitive craft into a teachable, reproducible discipline — and that philosophy is woven throughout this book.

Together, their combined expertise in surgical excellence and educational innovation is what makes this work unique.

About the Author: 

Rodrigo Fernandes, MD, PhD
Dr. Fernandes is a Minimally Invasive Surgeon of Endometriosis, Pelvic Oncology, Benign Pathologies, and is a World Endometriosis Society Ambassador at the Institute of Cancer of the State of São Paulo, Faculty of Medicine, University of São Paulo, Brazil. 

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