Reprinted from Annals of Gynecology and Pediatry, March, 1894. 
The Perfect Needle-Holder. 
V 
BY CHARLES P. NOBLE, M.D., 
PHILADELPHIA. 
Every active surgeon has large 
opportunities for employing a needle- 
holder. Every gynaecologist who 
does plastic work upon the genito- 
urinary organs, and who practises 
abdominal surgery after the modern 
technique, is obliged to employ a 
needle-holder. It is because the 
needle-holder is so valuable an in- 
strument that many surgeons have 
endeavored to improve upon the 
patterns in use. The result is a 
multiplicity of patterns, many of 
which are crude and useless. 
I desire to present an old needle- 
holder so improved by various sur- 
geons and instrument-makers that I 
think it may fairly be called the per- 
fect needle-holder. As I am not the 
inventor of the instrument, I feel the 
more free to insist upon its merits. 
The pattern upon which the instru- 
ment is based is known to “ the trade ” 
as the Reiner needle-holder. On evolv- 
ing the present pattern, advantage has 
been taken of all the improvements 
made by others, a new feature has 
been added, and the dimensions have 
been somewhat altered to accord with 
my theories as to what a needle-holder 
should be. 
The following are the measure- 
ments of the instrument: Point to 
pivot of joint, % in.; from pivot to 
joint of lock, 3f in.; from lock to end 
of handle, in.; total length of 
needle-holder, in.; width of handle 
at widest part, 2 in.; weight, oz. 
A perfect needle-holder should have 
the widest range of usefulness. It 
should combine in one instrument 
the advantages possessed by various 
others. It should be capable of grasp- 
ing both large and small needles, and 
both straight and curved needles. It 
should not only be available for sutur- 2 
CHARLES P. NOBLE. 
ing on the surface of the body, where 
room is abundant and suturing simple, 
but also in the recesses of the body, 
as in the upper part of the vagina and 
in the depths of the pelvis, where 
suturing is difficult and room is at a 
premium. The needle-holder under 
consideration presents all of these 
advantages. 'Some of its points of 
excellence are worthy of comment: 
(1) The beak of the instrument is 
narrow and tapers towards a point. 
blades of the holder being separated 
by a spring. Thus the locking ap- 
paratus is simple and almost auto- 
matic. 
(5) The handle is of such a form as 
to fit the hollow of the hand. This 
permits the free use of the thumb in 
managing the catch, and is of special 
service when curved needles are em- 
ployed, because these are best passed 
by a movement of supination of the 
forearm, wrist, and hand. 
Fig. i. 
Fig. 2. 
Thus curved needles can be grasped 
without breaking them. 
(2) The joint is of the French pat- 
tern. All the parts of the instrument 
can be taken apart easily to be cleaned. 
(3) The shank is light enough 
to be elastic, but heavy enough to 
be strong. This feature permits the 
grasping of large or small needles 
equally well. 
(4) The lock or catch is self-locking 
when the needle is grasped. The 
holder is unlocked by simple pressure 
of the thumb against the catch, the 
The handle of the instrument pre- 
sented is intended for a hand of 
medium size. An operator with a 
very small hand could work better 
with a needle-holder having a slightly 
narrower handle in.), and the re- 
verse is true of an operator with a 
very large hand, especially should the 
joints of the thumb not be supple. 
This last matter is one of great im- 
portance, as, should the handle be too 
narrow or too short for the hand that 
uses it, the unlocking of the catch 
becomes extremely awkward.