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The task Needle Driving (Needle Guidance) is dedicated for the training of ambidexterity, needle-holder manipulation, proper needle positioning in the jaws of needle-holder and visual-spatial coordination.
The task was originally developed for BESTA.
- Learn how to insert the needle into the working space;
- Learn how to grasp the needle;
- Acquire skill of proper positioning of the needle in needle-holder;
- Correct needle driving through tissue in different directions;
- How to pull thread safely through the tissues;
- Visual-spatial orientation; fulcrum effect compensation; coordinated movements of both instruments; ergonomic body and hands position.
Equipment: two needle-holders 5 mm; platform for task 1 (Peg Transfer); silk or other dark braided suture 15 cm long, 2-0, on taper needle 25 mm, ½ circle; red rubber band width 4 mm, diameter 25 mm, thickness 1 mm.
Setup: Peg Transfer Platform is positioned in the way that rectangle is on non-dominate side, and hexagon – on dominate side (i.e. for right-handed – hexagon on the right side). The red rubber band is stretched on the right pins in form of hexagon.
Aim of the task: pass through rubber band needle with thread in six points.
Performance: Grasp the needle by the thread – that assures secure insertion. Insert the needle into the training Lap-Box. Position the needle in jaws of right needle-holder and stitch the rubber strip in the space between two pins on the right side, from outside inwards. Drive the needle through the rubber by rotation movement. Pull the thread through the ribbon, so only the short end of the thread is left. Pull it not directly by needle, but using the second needle-holder. This technique is less traumatic for tissues and helps to keep the needle visible on the screen. Repeat stitches in and out in the neighbouring intervals, shifted in a counter-clockwise direction. For safety reasons make sure that the needle is constantly visible on the screen. After all six spaces between the pins will be sutured remove the instruments from the box.
Proficiency: the task should be preformed in 200 seconds. This level of performance should be demonstrated on 2 consecutive attempts. If a trainee cannot achieve this level of performance after 80 repetitions, that trainee should proceed to the next task.
Start: Instrument is inserted to the Lap-trainer (visible on the screen)
Finish: Last instrument is removed from the Lap-Trainer
- Time limit (sec): 600
- Target time (sec): 200 (further validation is needed)
- Passing score: 100
- Ambidexterity, %: 50-70%
- By inserting the needle-holder grasped the needle, not the thread;
- Needle was grabbed in the wrong place;
- By stitching tissue needle was not revolving;
- Needle frequently disappeared or longer was not visible on the screen;
- By pulling thread through the tissues used needle, not the second instrument;
- Non-ergonomic position of the trainee, leading to back or hands strain.
No penalties for errors
Wrong performance of the task, wrong position of the stiches
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Time limit (sec): 600 Time target (sec): 120 Number of points: 100 Ambidexterity, %: 0 Evaluated parameters: Formula: Formula Score = 220 – t (sec)
Compare with you:
X Date Attempt
Path, mm Av.Speed, mm/sec Max.Speed, mm/sec
Target values: 100 120 0 - - - - - -