Frimand Needle Holder Reduces Suturing Time and Surgical Stress When Suturing in Palm Grip.

Purpose The Frimand needle holder (FNH) was developed to facilitate palm grip suturing. In the present study, we wanted to examine the impact of the FNH compared with a conventional Hegar-styled needle holder (HSNH) on suture time and surgical stress. Methods Thirty-two surgeons were enrolled and they performed sets of 3 continuous sutures on a polyurethane pad with premarked insert and exit points and the time for suturing was measured. Surgical stress was quantified by having the surgeons to perform 10 release maneuvers with the FNH and the HSNH on a needle attached to a scale. The scale sent 5 values per second to a computer. The first measurement of each series was regarded as the starting weight and all subsequent measurements were either regarded as neutral, pressure or traction. The sum of these measurements represented total surgical stress. Results We found that all surgeons reduced their median suturing time by 16% when using FNH for palm grip suturing with no difference between junior and senior surgeons. Moreover, it was observed that FNH decreased median surgical stress by 62% for all surgeons performing palm grip suturing compared with a conventional HSNH. Conclusion We conclude that the FNH reduces suture time and surgical stress compared with HSNH when performing palm grip suturing. These findings warrant studies in surgical patients in order to evaluate the potential clinical impact of FNH.

A new needle holder facilitating palm grip suturing.

PURPOSE: The finger grip and the palm grip are the most common needle holder grips for hand suturing in surgery. The major advantages of the palm grip are an increased versatility and the possibility to apply controlled force. However, there is a risk for a potential loss of precision and uncontrolled movement of the needle when disengaging the ratchet mechanism of the palmed instrument. The purpose of this study was to develop a new needle holder, referred to as the Frimand needle holder (FNH), and evaluate surgeons' perception of it. It was designed to overcome the above-mentioned disadvantages, hence facilitating palm and finger grip suturing. Moreover, we evaluated suture precision and attitudes related to the use of the finger grip and the palm grip. METHODS: Thirty-two surgeons performed sutures utilizing both the palm grip and the finger grip on postmortem porcine skin and small bowels, comparing the FNH to a standard Crile-Wood needle holder (CWNH). The participants assessed the FNH on an evaluation form. Precision was determined by letting the surgeons perform 20 sutures utilizing the finger grip and the palm grip on a polyurethane pad with premarked insert and exit sites. The distance between the designated exit site and the real exit site defined precision and was measured with a digital sliding dimension scale. RESULTS: We found that 28 (88%) of the 32 surgeons use the palm grip to some extent, and 31 surgeons (97%) experienced an advantage when suturing with the FNH using the palm grip. Twenty-four (75%) of the 32 surgeons would prefer to suture with the FNH instead of the CWNH. There was no significant difference in precision between the finger grip and the palm grip. CONCLUSION: This study presents a new needle holder facilitating palm grip suturing. A majority of the participants preferred the new FNH over the standard CWNH for hand suturing.