Seki S
Department of Acute Medicine, Okayama University Medical School, Japan.
Int Surg. 1994 Apr-Jun;79(2):172-5.
While using a needle for suturing in a restricted operating space, surgeons change the direction of the needle holder by modifying needle grips. Such directional changes, however, have not been analyzed systematically. The "left-hand rule", similar to Fleming's rule in physics, is proposed as a guide in comprehending these changes. When the thumb is assumed to represent the direction of the holder in the standard grip, the long axis of the index finger represents that of a grip in which the needle is held obliquely [oblique (Ob) grip]. In the usual (tip-ward) Ob grip with ordinary suturing (advancing the needle by supination), the holder is shifted in the direction opposite to the fingertip (towards the arm) and, in that with reversed suturing (by pronation), towards it. The middle finger represents a grip in which the needle is held after rotation [rotated (Ro) grip]. In the usual (counter-clockwise) Ro grip, the holder is shifted in the direction opposite to the fingertip (towards the back of the hand) in both ordinary and reversed suturing.
在受限的手术空间中使用缝合针时，外科医生通过改变持针方式来改变持针器的方向。然而，这种方向变化尚未得到系统分析。本文提出了类似于物理学中弗莱明法则的“左手定则”，作为理解这些变化的指南。当假设拇指代表标准握持中持针器的方向时，食指的长轴代表倾斜持针（斜向握持，Ob握持）时的握持方向。在普通缝合（通过旋前推进针）的通常（向尖端）Ob握持中，持针器向与指尖相反的方向（向手臂方向）移动，而在反向缝合（通过旋后）时，则向指尖方向移动。中指代表旋转后持针（旋转握持，Ro握持）的握持方式。在通常的（逆时针）Ro握持中，无论是普通缝合还是反向缝合，持针器都向与指尖相反的方向（向手背方向）移动。
