Palming needle driver

For example, blunt jaws may be used when the operator desires to grab or manipulate tissue and minimize tissue damage. In operation, a user holds the first elongated body in a hand with a digit on the digit receiver To open the closed jaws shown in FIG.

The tension in the arms and , or the spring , which bias the first jaw member and second jaw member away from each other, causes the first and second jaw members to separate thereby creating a gap between them.

The user then inserts a tool, such as a needle for suturing, between the first jaw member and the second jaw member and moves the actuator with the digit receiver in the direction of arrow to clamp the tool between the first and second jaws. As the actuator is moved in the direction of arrow , the tooth on the flexible arm engages with the teeth on the serrated edge located on the interior portion of the first end of the first elongated body The actuator can be locked in a predetermined number of positions depending on where the tooth aligns with the teeth of the serrated edge.

In this manner, the user can adjust the clamping force on the tool and can grasp, secure, and lock tools of a varying size between the first and second jaws. After locking the needle between the jaws, the user can easily manipulate the needle driver by rolling it between his fingers, with the knurled surface of the first elongated body providing a positive grip surface and reducing slippage between the needle driver and the user's fingers.

While the first elongated body is typically cylindrical, it could also be multi-sided, such as square, hexagonal, or octagonal. Various shapes could be provided, depending on the users' preferences. The needle has a forward end and a rearward end Once the rearward end of the needle is locked in the jaws, the user typically proceeds with suturing by driving the needle through the tissue with the needle driver.

Once the needle passes through and the forward end of the needle is exposed on the far side of the tissue, the user releases the needle from the needle driver by pushing down on the actuator to disengage the tooth from the serrated edge and sliding the actuator back in the direction of arrow , or by sliding the actuator in the direction of arrow and allowing the tooth to ratchet over the serrated edge The user then grabs the forward end of the needle with the needle driver, locks the jaws on the forward end of the needle, and pulls the needle through the tissue.

To ready the needle for the next suture, the needle is released from the needle driver and is then grasped by the needle driver at the rearward end of the needle.

The needle is then driven through the tissue and the process is repeated. As before, an outer surface of the first elongated body may be knurled to allow the user to maintain a positive grip on the needle driver. At least partially disposed in the substantially hollow portion of the first elongated body is a second elongated body having a first end , a second end , and an actuating mechanism and a locking device disposed therebetween.

The first end of the second elongated body includes a substantially hollow interior portion with an external dimension slightly less than the internal dimension of the first elongated member and an internal dimension sized to slide over and operate a clamping device A bar connects the first end of the second elongated body to the second end of the second elongated body.

The second end of the second elongated body has a flexible elongated bar connected to it. The flexible elongated bar includes the actuating mechanism and locking device The locking mechanism has an engaging section for mating with a receiver located in the connector described later.

The actuating mechanism is used to move the flexible elongated bar to engage and disengage the locking device from the receiver Disposed in the second elongated body is the clamping device having a clamping end and a connecting end The clamping end of the clamping device has a first jaw member and a second jaw member opposing the first jaw member.

First arm and second arm join the connecting end to the first jaw member and second jaw member. The connecting end of the clamping device is affixed to the inside of the first elongated body with the connector which is disposed in the first end of the elongated body Various methods can be used to bias the first and second jaw member away from each other.

For example, the material used to make the clamping device may be a spring steel that will allow the first and second jaw members to flex inward and outward. End of the first arm and end of the second arm may be fused together as shown in FIG. Also, clamping device may be made from a single piece of material with the connecting end bent to create a spring as shown in FIG. Alternatively, a spring may be disposed between the first arm and the second arm as shown in FIG.

The connector is sized to fit inside the substantially hollow portion of the first elongated body and is spaced a distance from an interior surface of the first elongated body to allow the bar to pass between the connector and the interior surface The connector defines a hollow interior portion sized to receive the engaging section of the flexible elongated bar Disposed in the hollow interior portion is a receiver that mates with the engaging section of the locking device In this embodiment, the receiver is a tooth and the engaging section is a serrated edge that mates with the tooth.

Other locking mechanisms may also be used. For example, the receiver could be a serrated edge that mates with a tooth of the engaging section. Similar to the embodiment described previously, the first jaw member may have a pin that aligns with a hole with a diameter sized to receive the pin located in the second jaw member to align the jaws in the lateral direction.

In operation, a user holds the first elongated body in a hand with a digit on a digit receiver If the opposing jaws are closed, as shown in FIG. The tension in the arms, or the spring , which bias the first jaw member and second jaw member away from each other, cause the first and second jaw members to separate creating a gap between them.

The user then inserts a tool, such as a needle for suturing, between the first jaw member and the second jaw member and moves the actuator in the direction of arrow to clamp the tool between the first and second jaws.

As the actuator is moved in the direction of arrow , a tooth of the engaging section on the flexible elongated bar engages with the receiver located on the interior portion of the connector The actuator can be locked in a predetermined number of positions depending on where the receiver aligns with the teeth of the engaging section of the flexible elongated bar Grasping and releasing a tool and suturing are completed as described in the earlier embodiment.

Another embodiment is shown in FIGS. The needle driver could be used in traditional surgery or in laparoscopic surgery. ABG Quiz. Share Tweet. Last updated: November 12, Suggest an improvement. You don't need to tell us which article this feedback relates to, as we automatically capture that information for you. This allows us to get in touch for more details if required. Please write a single word answer in lowercase this is an anti-spam measure. This field is for validation purposes and should be left unchanged.

You might also be interested in the following guides: Horizontal mattress suture Vertical mattress suture Simple interrupted suture Suture materials Theatre etiquette.

You might also be interested in our OSCE Flashcard Collection which contains over flashcards that cover clinical examination , procedures , communication skills and data interpretation. Needle holder closed. Hold the forceps with your non-dominant hand in the same way you would hold a pen. Use your thumb and index finger to grip gently with the forceps.

Use the scissors to cut sutures. Use your index finger to increase your accuracy when using scissors. Load the needle between the apex of its curvature and two-thirds from the needle tip.

Ensure your needle is loaded in the tip of the needle holder. At the apex of the wound, pass your need from deep to superficial to begin your buried knot. Now pass your needle from superficial to deep on the opposite side to help bury the knot you tie.

Pull your suture through leaving a short length to tie to. Tie a standard knot as described in our simple interrupted suture video guide. Cut only the short end of the suture once you have completed your knot. Pass your needle from deep to superficial, so that the tip exits at the very apex of the wound within the dermis.

Insert your needle into the dermis near the apex of the wound, curving to take a bite of skin, and exit at exactly the same depth as your entry site 5mm along the wound edge. Perform the same manoeuvre on the opposite site, with your needle entry site adjacent the exit site of your last pass, or just proximal to it.

Pull your suture through to ensure the wound it sitting nicely. Implementation, construct validity, and benefit of a proficiency-based knot-tying and suturing curriculum.

Journal of Surgical Education, 65, Scott, D. A cost-effective proficiency-based knot-tying and suturing curriculum for residency programs. Listen to the coaches as they explain why this module can help trainees as they begin to learn to suture. Suture Characteristics. Handling the needle driver. You can palm it Figure A or insert your fingers in the holes Figure B. You should be facile with both techniques. Each serves a different purpose, and certain suturing situations will be easier with one over the other.

Practice opening and closing the driver with both the palming and finger-in-the-holes technique. As often as you can, handle the instrument and become totally comfortable using it.

It should become second nature to use. Notice which drivers are better suited to palming and which ones are better with fingers placed in the holes. Handling the needle correctly.