title: Improving the retention of suturing needles in surgical graspers.
abstract: 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.
authors.affiliation: Department of Surgery and Molecular Oncology, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK.
authors.forename: S I
authors.initials: SI
authors.lastname: Brown
authors.forename: G
authors.initials: G
authors.lastname: White
authors.forename: K
authors.initials: K
authors.lastname: Wipat
authors.forename: T G
authors.initials: TG
authors.lastname: Frank
authors.forename: A
authors.initials: A
authors.lastname: Cuschieri
mesh_terms: D004867:Equipment Design; D009339:Needles; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures