Needle Holder Demonstration

00:05 This instrument is a needle holder. Probably the most rudimentary tool that we're going to use in our training.

00:11 This is a six inch needle driver, needle holder, many names will call on the same.

00:16 You'll notice at the very tip here, there is a serration that has little grip ease on it for you to hold on to the needle with.

00:24 Very effective tool to help you securely grasp onto your needles.

00:28 If you don't have those little nubs on there, you'll find that sometimes the needle will slip off a little bit.

00:33 The instruments that you have a very high quality, and you'll find that they have a tungsten carbide insert in them.

00:38 That insert itself, you'll notice as a different color than the tissue of the metal around it rather.

00:43 Stainless steel around it as tungsten carbide.

00:46 It's a harder metals will actually, it'll damage your needle.

00:49 So be careful you grab on to the needle, if you get too far out to the pointy end of the needle, you'll bend and dull the point.

00:54 So when you hold the needle, it's very important that you hold it at the proper location.

00:58 A couple of things about this, obviously, this is where you grab your needles.

01:02 Do not ever grab tissue with these because you will damage the tissue and crush it.

01:06 This is where your lever is.

01:07 And basically the length of this, is the length of the fulcrum as far as your leverage goes.

01:12 So if you're really far away here, with larger instruments, it's easier to get more force here.

01:17 But that said, usually one or two clicks in your box lock is all you need to really securely hold that needle.

01:24 To break the box lock free, here's going to pop it up and see how this opens up by moving.

01:30 Be very careful that you don't get too far, and you can't undo it.

01:35 If your hands are weak, just really one click is all you need.

01:38 Okay, not a big deal.

01:39 So you can put your fingers in this if you prefer a thumb and one and typically your fourth finger and the other, and then your index finger down instrument.

01:47 Now that said you can also palm this by using your hand, just as a way to rotate around this and put your finger down the instrument.

01:55 This is the most common way, this instrument designed to be used, put the rings in the palm and just go like this.

02:01 To open this up when your palm did you're just pushing down with your fourth and fifth fingers on one part.

02:09 And then on the right hand, on thumb side, you're pushing up.

02:12 So basically separates those rings. Not a big deal.

02:15 Now for those that are lefties, it doesn't work very well to do this.

02:18 So if you're a lefty, you're going to have to choose to pop it open by kind of pulling down with your thumb away from this.

02:26 You can't palm them in puppet free as a lefty because it would only open it.

02:30 So it's really just a right hand technique to do this.

02:33 If you're in an operating room setting, you'll see that this is pretty much how everyone does it.

02:37 They just grab it and go.

02:38 You can rotate around almost any possible way.

02:42 Whereas, if you had your fingers in there, you're limited by the rotation of your wrist.

02:46 Realize it from my elbow down.

02:49 I'm trying to make an extension of my fingers down to the tip of the instrument.

02:53 So I don't have my wrist bent when I'm trying to use this.

02:56 That goosenecking is very difficult. You lose your range of motion.

03:00 And at the same time, you'd be very sore.

03:03 So the best thing you can do if you want to practice this from the right way from the beginning is to practice by palming it just to get the rotation down.

03:12 And it should be like this. This is the movement.

03:14 It's an extension right down the arm.

03:16 And then the instruments and extension of the finger. Okay? That's how you're supposed to hold these.

03:21 If you want to have the ultimate dexterity.

03:23 It's not wrong to put your fingers in them, There's holes there for a reason.

03:26 But that said, those, in my opinion, are there to get your fingers stuck not to actually let you control the actual tissue the best.

03:35 So always keep an instrument down. A finger down the instruments so that you can control it and keep your finger on it.

03:41 If you're back here, then you don't really have the strength and control what's going on.

03:46 Also, if you happen to have a finger down the instrument, if you get your fingers stuck. My thumb is stuck now.

03:51 I can't do anything to get it free.

03:53 I can help push that off with the index finger pushing away.

03:56 So that index finger can help you on stick it if you've got big fingers.

04:01 And depending on the quality of the instruments, you may have bigger or smaller holes in these.

04:04 These may be just single use metal, or this is meant to last your lifetime.

04:08 Okay, so it's matter of getting to know your instruments, become familiar with them.

04:12 They should be pretty frictionless and smooth.

04:14 Sometimes they're a little rough.

04:15 You may notice sutures are a little bit stiff because they're brand new, and that's okay.

04:20 But the more you use them, the more you get them broken in and the more they'll be easy to use.

04:24 When you palm in you're just putting some friction to open it up just a little bit. That's all it is slight movement.

04:28 So if you see me doing this as we're going through these videos, don't be surprised. That's all we're doing.

04:33 And mine is different than what you may be doing as you go, "What is he doing?" I'm just palming it because that's how I do it.

04:38 Because this is what I do for a living. Okay.

04:39 Get ready. We're going to have some fun.