ANGLED NEEDLE FOR SUTURING AURICULAR APPENDAGE IN COMMISSUROTOMY

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Abstract
The development of instruments necessary to perform a new operative technique do not keep pace with the surgical advance. The tools are fashioned of necessity and at first are makeshift. The ingenious aortic clamp of Potts and the rib retractor of Sinochietto are examples. Operating in the thoracic cage requires variations from standard instruments and needles. In the operation of mitral commissurotomy, a now accepted surgical treatment, the purse-string suture and over-sewing of the auricular appendage are of primary importance. Accidents or technical errors at this point, such as the slipping of a clamp or the tearing of the suture, not only are hazardous but may be fatal. The standard needle and needle holder are constructed so that the needle is grasped at right angles to its direction of insertion. Such clasping is adequate if the surgeon is able to lower his hand to a level parallel to the needle.

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