A Novel Grip-Type Microsurgical Needle Holder: Introduction and Electromyographic Evaluation

Y. Yasunaga, Daisuke Yanagisawa, Erika Ohata, S. Yuzuriha, S. Kondoh, K. Matsuo
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Abstract

Abstract Background We have newly developed a novel “grip-type” gun-shaped microsurgical needle holder that requires only finger twisting between the thumb and index finger for needle advancement. This study aimed to objectively assess whether this grip-type needle holder could reduce forearm muscle movement during microsurgical suturing as compared with a conventional pen-type needle holder by means of surface electromyography (sEMG). Methods Extensor carpi ulnaris (ECU) muscle and flexor carpi ulnaris muscle (FCU) sEMG measurements were taken during needle advancement in a microvascular anastomosis model for calculation of root mean square (RMS) values. The summed ECU and FCU RMS values were employed as indicators of forearm muscle movement and compared between the pen-type and grip-type instruments. Analyses of eight subjects and suturing in five directions by one subject were conducted. Results The summed ECU and FCU RMS values of the grip-type holder were significantly smaller than those of the pen-type holder in comparisons of eight subjects (p < 0.05). Similarly, the summed RMS values of the grip-type holder in each of the five suturing directions were remarkably lower than those of the pen-type holder. Conclusion The grip-type needle holder could significantly reduce forearm muscle movement as compared with a conventional pen-type holder based on objective sEMG measurements. The grip-type device appears more ideally suited for delicate microsurgical suturing, such as lymphaticovenular anastomosis or finger replantation, since the reduced forearm movement may mitigate the risk of coarse motion and hand shaking.
一种新型夹持式显微手术持针器的介绍及肌电图评价
摘要背景 我们最新开发了一种新型的“抓握型”枪形显微外科针头夹持器,该夹持器只需要手指在拇指和食指之间扭转即可推进针头。本研究旨在通过表面肌电图(sEMG)客观评估与传统笔型持针器相比,这种握持式持针器在显微外科缝合过程中是否可以减少前臂肌肉运动。方法 尺侧腕伸肌(ECU)和尺侧腕屈肌(FCU)的sEMG测量是在微血管吻合模型中进行的,用于计算均方根(RMS)值。ECU和FCU RMS的总和值被用作前臂肌肉运动的指标,并在笔型和握把型仪器之间进行比较。对八名受试者进行了分析,并由一名受试人员进行了五个方向的缝合。后果 在八名受试者的比较中,握把型握把的ECU和FCU RMS值之和明显小于笔型握把(p < 0.05)。类似地,抓握型保持器在五个缝合方向中的每一个缝合方向上的RMS值总和显著低于笔型保持器的RMS值。结论 与基于客观sEMG测量的传统笔型持针器相比,握持式持针器可以显著减少前臂肌肉运动。抓握式装置似乎更适合于精细的显微外科缝合,如淋巴管吻合或手指再植,因为减少前臂运动可以减轻粗动和手抖的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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14 weeks
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