AAGL Suturing Lecture

Suturing Techniques

Arnaud WATTIEZ, MDJoseph NASSIF, MD

AAGL Orlando 2009

Disclosure

• We declare that we do not have any relevant financial relationships or off-label uses

Suturing

• Needle Holders• Threads• Needles• Needle insertion • Loading the needle• Rotation of wrist & hand• Suturing

Needle holders

Needle holders

Instruments

Instruments

Instruments

Instruments

Instruments

• 3 mm trocars & instruments

• Fine suturing

• Congruence

Threads

• Threads– Absorbable– Non absorbable– Size

Threads

• In general,

Needles

Needles

Needles

Needle insertion through trocar

• 5 mm trocar

Needle insertion through trocar

• 10 mm trocar

Loading the needle

• Manipulate the needle with the tread

• Orientate your angle

Loading the needle

• Lay on tissue– Right hand– Left hand

Needle Manipulation Technique

Needle Manipulation Technique

• Right hand video

• Left hand video

Thread Manipulation Technique

• Right hand video

• Left hand video

Beware of errors !!

• Errors video

Loading the needle (Twist Technique)

• Twist video

Rotation of wrist & fingers

Suturing

• Z line running suture

– Master rotation principle– Train one hand at a time

Z line suturing

• movie

Suturing

• Greek running suture

– Master using both hands– Ambidextirity

Greek line suturing

• movie

Thank you for your attention !