Improving the retention of suturing needles in surgical graspers.

BACKGROUND

Surgical needles are usually held using dedicated grasping instruments. When the tissue to be penetrated is resilient, or the grasping force is low, the needle can swivel, causing it to deviate from the intended path, resulting in suboptimal tissue approximation. Needle swivel is particularly prevalent when needles are not held transversely in the jaws, but it is difficult to maintain a transverse grasp during surgery. An improved swivel-resistant grasper design is proposed.

METHODS

Conventional and swivel-resistant graspers were tested to quantify the benefits of the swivel-resistant design. Needles secured in the grasper were repeatedly distracted until swiveling occurred. The torque required to swivel the needles was statistically analyzed.

RESULTS

The swivel-resistant grasper offers greatly improved resistance to swivel (p = 0.01) when the needle is not held transversely.

CONCLUSIONS

The four-point contact afforded by the modified needle graspers imparts improved needle retention and resistance to swivel.