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Needle holding ability of laparoscopic needle holders

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Reflections & comments in 2005

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Suturing in the laparoscopic environment can stretch the limits of a surgeons patience and dexterity. When operating at these limits the ergonomics and needle holding characteristics of the needle holder become crucial to success. Seven needle holders were tested with an electronic balance for both needle holding ability and the hand flexion or extension forces required to activate them.

Results:

Force required to twist needle in closed jaw: 0.8oz to 5.4oz (mean 2.67oz, SD 1..55oz) (For comparison a force of 2.5oz is needed to drive a needle through soft skin).
Finger and thumb extension forces required to open spring loaded handles:
33oz to 90oz (mean 60oz, SD 30oz)
Flexion forces required to close handles: 67oz to 168oz (mean 118oz, SD 45oz)

The data confirm a wide variation in needle holder performance and suggest that the term "needle holder" may be inappropriate for some instruments. Features of a hypothetical ideal laparoscopic needle holder will be discussed..

Poster at SAGES 20xx

This is not primarily my paper. I made none of the measurements myself. However it did extend some early ideas of mine, as well as observations on the poor heedle-holding ability of early lap instruments, and fits nicely in this context.

The needleholders in the Da Vinci robotic surgery system (Intuitive Surgery, Sunnydale CA), released 2004, are rock-solid in this regard.

ERGONOMICS AND NEEDLE HOLDING ABILITY OF LAPAROSCOPIC NEEDLE HOLDERS.

John Cartmill,M.B.,B.S., *Michael Patkin M.B.,B.S., John G. Graber M.D., Leonard S. Schultz M. D., David F.Hickok M.D., *Louis Isabel,M.B.,B.S., Abbott Northwestern Hospital, Minneapolis, Minnesota. *Whyalla Hospital, Whyalla, South Australia.