Surgical needle abstract
A surgical needle holder is provided for guarding the tip of a
needle in an inoperative position. The needle tip is guarded in
the inoperative position in retaining means such as a groove or
slot associated with the jaws of the needle holder.
Surgical needle claims
What I claim is:
1. A surgical needle holder which comprises:
a) a pair of elongate members which are linked together at a pivot
point in scissors-like fashion and which include projecting jaw
portions forming jaws for releasably holding a surgical needle;
b) handle portions for opening and closing the jaws, said handle
portions being shaped to provide a gap between the handle portions
in the region of the pivot point when the projecting jaw portions
are closed, said gap being dimensioned to receive a tip of the surgical
c) wherein at least one of said handle portions includes a protrusion
extending therefrom and towards the other handle portion, said protrusion
located on said at least one handle portion to extend into said
gap so as to guard the tip of the needle and prevent the needle
tip passing between the handle portions.
2. The surgical needle holder of claim 1 wherein said protrusion
is located on a face of one of said pair of handle portions between
said pivot point and a proximal end of said one of said pair of
Surgical needle description
FIELD OF THE INVENTION
This invention relates to surgical instruments and in particular
to a novel needle holder.
The increasing perception of risk of infection of medical personnel
by contact with patients body fluids has led to various measures
in an attempt to reduce the likelihood of infection. There is particular
concern over the possibility of transmission of hepatitis B virus
(HBV) and human immuno deficiency virus (HIV) to health workers
in the course of their patient care duties. In the case of surgeons
and other theatre workers, needle stick injuries are relatively
common and surgical gloves do not provide complete protection. In
one recent study it was found that in 54% of caesarean sections,
one or more glove punctures were found to have occurred to the surgeon's
gloves. Attempts have been made to reduce the puncture rate, for
example, by adopting a practice of double-gloving and using blunt-tipped
needles. While blunt tipped needles do reduce the number of punctures,
perhaps by a factor of about 1.5 the rate of puncturing is still
SUMMARY OF THE INVENTION
It is, therefore, an object of the invention to provide a needle
holder which, in use, is capable of reducing the risk of needle
stick injury and glove puncture in surgical operations.
According to one aspect of the present invention there is provided
a surgical needle holder which comprises a pair of jaws for holding
a needle, while inserting stitches into tissue and retaining means
associated with the jaws for retaining the tip of the needle in
an inoperative position, in which the user's hand is protected from
contact with the needle tip.
The retaining means may comprise an aperture, recess or groove
formed in part of the jaws of the instrument, the aperture recess
or groove being dimensioned to receive the needle tip. In an alternative
arrangement, the jaws or the handles of the needle holder are shaped
to provide abutments adapted to grip the needle tip or an elongated
gap in which the needle tip can be lodged in the inoperative position.
The needle holder is preferably provided with the retaining means
on opposite sides of the jaws so that the needle holder can be used
either way up.
The needle holder in accordance with the invention is intended
to be used with both blunt tipped and sharp needles and needles
of various diameters. For this reason, the retaining means, such
as a groove, when viewed in cross-section, has an inward taper.
BRIEF DESCRIPTION OF THE DRAWINGS
Further features and advantages of the invention will become apparent
from the following description and accompanying drawings, in which
FIG. 1 is a perspective view of a needle holder in accordance with
the invention, showing the needle in the operative position,
FIG. 2 is a section along the line A--A in FIG. 1 on an enlarged
FIG. 3 is a view, partly in section taken along the line B--B in
FIG. 1 and again on an enlarged scale,
FIG. 4 shows a plan view of the jaws section of a second embodiment
of a needle holder in accordance with the invention,
FIG. 5 shows a plan view of the jaws section of a third embodiment
of a needle holder in accordance with the invention,
FIG. 6 is a plan view of a fourth embodiment in accordance with
the invention, and
FIG. 7 is a view taken on the line C--C in FIG. 6.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring the accompanying drawings, the needle holder comprises
a pair of jaws generally indicated at 1 and which can be opened
and shut using the handles 2. The action of the jaws is a scissor-like
action pivoted in the general region of a pivot point 3. As shown
in FIG. 1 a needle 4 is held in the jaws with thread 5 attached
to the needle end and the needle tip 6 used to insert stitches in
conventional manner to suture the wound. The needle holder normally
incorporates a ratchet-type lock schematically indicated at 17.
After inserting stitches into the wound, it is common practice
for a surgeon to leave the needle locked into the jaws and to slide
his hands down the instrument to grip the surgical thread and firmly
close up the wound. It is at this point that it is believed that
a number of glove punctures and needle stick injuries occur. In
accordance with the invention, at this point in the suturing of
the wound, the needle 4 is rotated in the jaws so that the needle
tip 6 is received in a groove 7 in which it is releasably retained.
In this position (which is indicated in FIG. 3), the needle tip
is guarded within the groove and the surgeon is protected from any
needle stick injury. He can therefore complete the tying of the
surgical suture without risk of glove puncture. Also, when the surgeon
passes the needle and needle holder to the theatre nurse, the needle
should be passed in the inoperative position.
The groove 7 is formed in one or both components of the jaw 1 and
in one embodiment is shaped as shown in FIG. 2 at an inwardly tapering
groove. The advantage of this kind of shape is that the groove can
accommodate needles of various tip sizes. The length of the groove
7 is also chosen so that it can accommodate a variety of needles
of different diameter R (see FIG. 3). It may also be advantageous
to provide the inner surface of the groove 7 with a milled or roughened
surface for better retention of the needle tips. An inwardly tapering
groove can also be used with blunt-tip needles and these are advantageously
used together with the needle holder of the invention, so as to
further reduce the risk of needle stick injury.
Rotation of the needle from the operative to the inoperative or
parked position shown in FIG. 3 is preferably carried out using
forceps to rotate the needle into the parked position. Suitable
forceps for this purpose are described in UK Patent Application
No. 2210574 the contents of which are hereby incorporated by reference.
A second embodiment of the invention is shown in FIG. 4. This embodiment
corresponds with that shown in FIGS. 1 to 3 except that instead
of a groove, one or both jaws 1 are formed with a series of holes,
recesses or depressions 21. Such holes, recesses or depressions
may also be inwardly tapered so as to accommodate needle tips of
different sizes. Preferably, the holes or recesses 21 are formed
on the face of both jaws 21 so that the needle tip can be received
in an appropriate hole whichever way up the needle holder is used.
A third embodiment is shown in FIG. 5. In this embodiment, instead
of providing a groove in the jaws 1 the proximal end of the jaws
are modified to form a slot 31. This slot may be tapered inwardly
to accommodate needle tips of different sizes.
Referring to FIGS. 6 and 7 a fourth embodiment comprises a needle
holder having jaws 1 formed by a pair of handles 10 11 pivotably
attached at a pivot point 12. Handle 10 includes a web-like plate
14 attached to the handle 10. Plate 14 extends into a slot formed
in the handle 11 and the two handles are pivoted about a pin 12.
Plate 14 has an extension in the direction of the finger grips 16.
Handles 10 and 11 are so shaped in the region of the rearward plate
extension 15 that when the needle holder is closed, an enlarged
gap 20 or 21 exists between the arms of the handles. A ratchet closure
17 enables the needle holder to be held in a closed position without
maintaining finger pressure on the handles. The inward faces of
the portions of the arms 10 and 11 which form the sides of the gap
20 or 21 may be sloped inwardly so as to form inwardly tapered slots
In a modification of the embodiments shown in FIG. 5 or FIGS. 6
and 7 additional retaining means (e.g. a groove or recesses) may
be formed in one or both faces of the jaws in the region of the
pivot point. This arrangement allows needles to be accommodated
which have a larger range of diameters.
Preferably, the retaining means comprise a groove or slot having
a substantially uniform width. In comparison with a standard needle
holder, it may be desirable to shift the pivot point forward (i.e.
in the direction of the open end of the jaws), in order to provide
the maximum length of available area for locating the groove and/or
slot. Also, in order to be able to provide retaining means of significant
width and depth, the bulk size of the needle holder in the region
of the jaws may need to be increased compared with some standard
or conventional needle holders.
In a more elaborate design, the needle holder may be modified by
the provision of a rolling hinge. In such a modification, movement
of one handle axially with respect to the other causes the needle
to rotate from its operative to its inoperative position, without
needing to touch the needle with forceps. Once the needle is in
its inoperative position, the tip may then be urged into a retaining
means such as a groove.