Surgical eyeless needles are manufactured in a wide range of types, shapes, lengths and thicknesses. The choice of needle to be used depends on several factors such as:
Figure 60
The point depends on the needle type (see next section). The body of the needle usually has a flattened section where the needle can be grasped by the needle holder. In addition some needles have longitudinal ribs on the surface which reduce rotational movement and ensure that the needle is held securely in the jaws of the needle holder. If the needle does not have a flattened section, it should be grasped at a point approximately one-third of the needle length from the butt (Figure 61).
Figure 61
The majority of surgical needles nowadays are eyeless, that is they are already swaged to the suture material. This has many advantages, including reduced handling and preparation and less trauma to the tissue. (A needle with an eye has to carry a double strand which creates a larger hole and causes greater disruption to the tissue). A swaged (eyeless) needle has either a drilled hole or a channel at the end of the needle for insertion of the suture material. The drilled hole or the channel is closed round the needle in the swaging process.
Needles are normally classified according to needle type. The main categories are described in this section.
Round-bodied needles are designed to separate tissue fibres rather than cut them and are used either for soft tissue or in situations where easy splitting of tissue fibres is possible. After the passage of the needle the tissue closes tightly round the suture material, thereby forming a leak-proof suture line which is particularly vital in intestinal and cardiovascular surgery.
| Needle type | Description | Typical application |
| Intestinal |
The hole made by this needle is |
Gastrointestinal tract; biliary tract; dura; peritoneum; urogenital tract; vessels; nerve. |
| Heavy | In some situations where particularly strong needles are required, a heavy wire diameter needle would be appropriate. | Muscle; subcutaneous fat; fascia; pedicles. |
| Blunt taperpoint | Where needlestick injury is a major concern, particularly in the presence of blood borne viruses, the blunt taperpoint needle virtually eliminates accidental glove puncture. | Uterus; pedicles; muscle; fascia. |
| Blunt point | This needle has been designed for suturing extremely friable vascular tissue. |
Liver; spleen; kidney; uterine cervix for incompetent cervix. |
Cutting needles are required where tough or dense tissue needs to be sutured.
|
Needle type |
Description |
Typical application |
| Tapercut™ | This needle combines the initial penetration of a cutting needle with the minimised trauma of a round-bodied needle. The cutting tip is limited to the point of the needle, which then tapers out to merge smoothly into a round cross-section. | Fascia; ligament; uterus; scar tissue. |
| Cutting | This needle has a triangular cross- section with the apex on the inside of the needle curvature. The effective cutting edges are restricted to the front section of the needle. | Skin; ligament; nasal cavity; tendon; oral. |
| Reverse cutting | The body of this needle is triangular in cross-section with the apex on the outside of the needle curvature. | Skin; fascia; ligament; nasal cavity; tendon; oral. |
In addition, there are surgical needles for specialist areas, such as microsurgery, opthalmics and endoscopic surgery.
The choice of needle shape is frequently governed by the accessibility of the tissue to be sutured. Normally, the more confined the operative site, the greater the curvature required. The following table shows the basic shapes and typical applications.
