“Ski”-Shaped Microneedle Facilitates Suturing in a Deep Narrow Surgical Field

Background: Microsurgical suturing requires high level of dexterity and practice. Suturing in a deep and narrow operative field poses additional difficulties mainly due to the long microsurgical instruments and the difficulty of manipulating a curved needle. Objective: In this technical note, we describe a simple modification of a classical curved suture needle into a “ski”-shaped needle. Methods: A classical curved needle is stretched using a needle holder. Only the tip of the needle is left slightly bent, imitating a ski. Once the needle is bent into the ski shape, it can be grasped virtually in any position with the needle holder. Results: We have used the ski needle technique suturing in several patients in which the operative field was deep and limited such as dura repair in spinal surgery in obese patients, facial nerve grafting in the internal acoustic meatus and posterior inferior cerebellar artery suturing between the caudal cranial nerves. Conclusion: This modification facilitates free positioning of the needle in the needle holder and as a consequence results in easy and faster microsuturing in a deep and narrow operative field. The ski needle technique was felt to be superior to the classical curved needle technique.

HALF-CUTTING METHOD during Hysterectomy for Large Uterine Cervical Myoma

Hysterectomy for large uterine cervical myoma is a challenging surgical procedure due to the limited operative field for lateral and posterior dissections. Existing procedures such as performing myomectomy before hysterectomy or performing retrograde hysterectomy remain suboptimal in expanding the operative field, especially in cases with a huge cervical myoma. In this report, we introduce a new procedure, the “HALF-CUTTING METHOD” which can be used to obtain an adequate surgical field during hysterectomy.