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.