The ubiquitous SH needle, used for many applications.

It stands for ‘Small Half’ circle.

There are also MH, LH, XLH, and even XXLH…not shown here.

It turns out that all of the needle designations have a meaning…
Short 🧵.
CT stands for ‘Circle Taper’

Note these are tapered needles.
There is CT (40 mm) and then CT-1 is a little smaller at 36 mm.
There is also a CT-2 (not shown - it is 26 mm)
PS stands for ‘plastic surgery’.
This is a PS-1.
It continues with PS-2 and PS-3, which are smaller. These are 3/8 circle.

PS-4, -5, and -6 exist, and these are slightly different at 1/2 circle.
The famous UR-6 needle. It is 5/8 circle.

No tricks here—the UR stands for ‘urology’. I don’t know what they use it for, but general surgeons use it for closing fascia of 12 mm trocar sites.

UR-4 and UR-5 exist, and these are larger.
This symbol stands for ‘controlled release’.

In the US, we commonly call these ‘popoffs’. Perhaps they are called other things elsewhere.

These needles are designed to pop off when the suture is pulled.
This is a Keith needle. Very old-school here. In its current interation, it is a reverse cutting needle.

It is named for Thomas Keith, a surgeon in Edinburgh in the 19th century. He seemed to have led an interesting life that would be a good thread on its own.
This is from the Ethicon Wound Closure manual, where I got some of this material. it shows all of the Ethicon codings for needles. Other brands sometimes use other codes.
Interestingly, I came across a 3-0 prolene on a Keith needle.

If anyone has an idea what this might be used for, I’d be interested. I don’t think I’ve seen it before.
One may also obtain both straight and curved needles that do not have a suture on them. These are Richard-Allan needles.

I am not sure which specialties make regular use of these.

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More from @rbarbosa91

Jun 3
🧵on 'French' and 'Gauge'

The 'French' unit of measurement was once known as the 'Charrière', after Joseph-Frédéric-Benoît Charrière, a Swiss knifemaker who moved to France in 1820 and became a manufacturer of surgical instruments.

1 Fr = 1/3 mm.

It was renamed because...
...English speakers had a hard time pronouncing 'Charrière".

The Fr number refers to the OUTER DIAMETER of the catheter. A 12 Fr Foley has a 4 mm outer diameter, and a 7 Fr central line has a 2.33 mm outer diameter, regardless of the number or configuration of lumens.
Note that the lumens are different diameters. The BROWN (distal) lumen will have the highest flow rate.
Note the numbers on the different lumens, corresponding to the flow rate. The brown port has *twice* the flow of either the white or the blue ports.
Read 9 tweets
May 31
Thread showing some operations that are similar in RVU to a laparoscopic cholecystectomy. First:

Lap chole: 47562 — 10.47 RVU
LC + IOC: 47563 — 11.47 RVU

Here we go:
Incarcerated femoral hernia — 11.92
Partial oophorectomy — 11.95
Drain prostate abscess — 10.05

(1/ )
Revision VP shunt — 11.43
Partial thyroidectomy — 11.23
Glaucoma surgery — 10.52
Repair lumbar hernia — 10.74
ORIF sternum — 11.4
Insert tissue expander — 11.49
I&D sacral pressure ulcer — 11.77
Reconstruct cleft palate — 9.77
Laser surgery prostate — 11.3
Femoral a.stent — 11.75
Forearm fasciotomy — 10.79
Repair finger tendon — 11
Repair knee ligament — 10.85
Above knee amputation — 10.98
Open G-tube — 10.85
ORIF mandible — 11.01
Open appendectomy — 10.6
Open appy (perforated) — 14.6
Read 4 tweets

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