Suture needles and sutures with needles

Abstract

To provide a suture needle and a suture with a suture needle that improve an esthetic outcome and are to be used in an operation such as surgery and plastic surgery operations.SOLUTION: A suture needle 10 has a sharp tip 12 and a base end 13 to which a suture is to be attached. The suture needle comprises: a first curved part 14 on the tip side; and a second curved part 15 on the base end side, the second curved part 15 being more strongly curved than the first curved part 14. The first curved part 14 is configured so that after the first curved part is inserted from an incision surface, the first curved part is made to advance to the depth of tissue after the degree of curvature of the first curved part 14.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to suture needles and sutures with attached needles for use in surgical procedures such as plastic surgery. [Background technology]

[0002] In recent years, minimally invasive surgery has progressed in surgery and plastic surgery, and there is a demand for reducing postoperative and post-healing scars. To achieve this, it is important to reduce tension around the scar. Increased tension in the scar after suturing reduces blood flow around the scar, delaying wound healing and causing problems. Therefore, subcutaneous or intracutaneous suturing is effective in reducing tension on the skin surface in areas such as joints that move frequently and the abdomen where abdominal pressure is applied.

[0003] Furthermore, since cosmetic appearance is required for skin suturing, it is important to use a suturing technique that does not expose the suture thread on the surface.

[0004] Dermal suture is a technique for suturing the dermis, which is the subcutaneous tissue, and it maintains blood flow to the tissue around the scar and reduces tension at the scar, thereby reducing scarring after surgery and healing (e.g., Non-Patent Document 1).

[0005] Dermal suturing using a conventional strongly curved suture needle (hereinafter referred to as a "conventional needle") 30 will be described below with reference to Figure 9. In Figure 9, the skin structure to which dermal suturing is to be performed has epidermis 1, dermis 2, and fat (subcutaneous structure) 3, and covers muscle 4.

[0006] As shown in Figure 9, when using a conventional needle 30, first, the conventional needle 30 to which the suture 36 is attached is held with a needle holder and inserted into the fat 3 (or below the dermis 2) at one of the wound edges (incision surface) 5, and the needle holder is rotated (Figure 9(a)).

[0007] After the needle has been inserted, the needle holder is rotated so that the trajectory is an arc following the curvature of the circle, and the needle is advanced and then pulled out from above the dermis 2 on one of the incision surfaces 5 (FIG. 9(b)).

[0008] Next, the conventional needle 30 is inserted into the upper part of the dermis 2 or into the epidermis 1 on the other incision surface 5, and the needle is advanced by rotating the needle holder so that the trajectory follows the curvature of the circle and forms an arc, and then pulled out from below the dermis 2 on the other incision surface 5 (Figures 9(c)-(e)).

[0009] Finally, the suture 36 is ligated in the fat 3 (or below the dermis 2) (FIG. 9(f)). The ligation point 36_2 is shown in the figure.

[0010] In this way, in dermal sutures, the dermis 2 is sutured with a stiff needle at a predetermined depth from the surface of the wound edge. As a result, tension can be reduced in the area from the suture position in the dermis 2 to the surface of the wound edge, and tensile strength can be maintained for a certain period of time, allowing the wound to heal smoothly. [Prior art documents] [Non-patent literature]

[0011] [Non-Patent Document 1] "How to Care for Surgical Scars: Aiming for Inconspicuous, Clean Scars" (Supervised by Norihiko Oura, published by 3M Japan Co., Ltd.) https: / / aaa-amputation.net / wp-content / uploads / 2020 / 11 / 2020-6-22_3M_Document2.pdf Summary of the Invention [Problem to be solved by the invention]

[0012] However, if the distance between the suture position, i.e., the position that causes tension reduction (hereinafter referred to as the "point of tension reduction") and the surface of the wound edge is long, the wound edge will not heal well, and even if tension is reduced sufficiently, the cosmetic appearance of the scar will not be improved. Thus, it is technically difficult to suture a specified area in the lower region (subdermal layer) of the fat 3 or dermis 2 using a conventional strong curve suture needle (conventional needle) 30.

[0013] In order to perform strong dermal sutures, it is necessary to advance the suture needle 30 deep into the tissue from the wound edge (incision surface) 5. Furthermore, it is necessary to evert the epidermis 1 so that it does not turn inward (to prevent inversion) into the wound.

[0014] However, in conventional dermal suturing using a suture needle 30, the suture needle is advanced following the curvature of a circle, making it difficult to advance the suture needle 30 from the wound edge (incision surface) 5 deep into the tissue and perform suturing.

[0015] Furthermore, the skin must be pulled upward to achieve eversion. If excessive force is applied, it can damage the skin tissue, reduce blood flow around the wound, and delay wound healing. This can also cause necrosis of the wound edge, which is problematic. [Means for solving the problem]

[0016] In order to solve the above-mentioned problems, the suture needle according to the present invention is , ahead A suture needle having a pointed end and a suture thread attached to a base end, characterized in that it has a first curved portion at the tip end and a second curved portion at the base end, the first curved portion and the second curved portion being circular, the second curved portion being more strongly curved than the first curved portion, and the angle formed by the tangent at the base end of the second curved portion and the tangent at the other end opposite the base end is greater than 67.5° and not more than 100°.

[0017] Furthermore, the suture needle according to the present invention may be configured so that, after the first curved portion is inserted from the incision surface, it can be advanced deeper into the tissue in accordance with the degree of curvature of the first curved portion.

[0018] Furthermore, the suture needle according to the present invention may be configured such that the second curved portion changes its direction of advancement toward the incision surface deep in the tissue in accordance with the degree of curvature of the second curved portion.

[0019] Furthermore, the suture needle according to the present invention may be configured so that the first curved portion is pulled out in a direction substantially perpendicular to the incision plane in accordance with the degree of curvature of the first curved portion.

[0020] In the suture needle according to the present invention, the angle formed by a tangent at the tip and a tangent at the other end opposite the tip in the weakly curved portion may be greater than 0° and not greater than 67.5°.

[0021] In the suture needle according to the present invention, the angle formed by a tangent line at the base end and a tangent line at the other end opposite the base end in the strongly curved portion may be greater than 67.5° and not greater than 100°.

[0022] A suture thread with a suture needle according to the present invention comprises the suture needle and a suture thread. [Effects of the Invention]

[0023] According to the present invention, it is possible to provide a suture needle and a suture with a suture needle that can improve the cosmetic appearance of suturing. [Brief explanation of the drawings]

[0024] [Figure 1] FIG. 1 is a schematic view of a suture needle according to a first embodiment of the present invention. [Figure 2] FIG. 2 is a diagram for explaining the operation of the suture needle according to the first embodiment of the present invention. [Figure 3] FIG. 3 is a diagram for explaining an example of the operation of the suture needle according to the first embodiment of the present invention. [Figure 4] FIG. 4 is a diagram for explaining an example of the operation of the suture needle according to the first embodiment of the present invention. [Figure 5] FIG. 5 is a diagram for explaining the function and effect of the suture needle according to the first embodiment of the present invention. [Figure 6] FIG. 6 is a view for explaining an example of a suture needle according to the first embodiment of the present invention. [Figure 7]FIG. 7 is a view for explaining an example of a suture needle according to the first embodiment of the present invention. [Figure 8] FIG. 8 is a schematic view of a suture thread with a suture needle according to a second embodiment of the present invention. [Figure 9] FIG. 9 is a diagram for explaining the operation of a conventional suture needle. DETAILED DESCRIPTION OF THE INVENTION

[0025] First Embodiment A suture needle according to a first embodiment of the present invention will be described with reference to FIGS.

[0026] <Suture needle configuration> 1(a) and 1(b) are a perspective view and a side view, respectively, of a suture needle 10 according to this embodiment.

[0027] The suture needle 10 according to this embodiment has a curved body 11, a sharp tip (needle tip) 12, and a base end 13 to which a suture thread (not shown) is attached.

[0028] There are no limitations on the cross-sectional shape of the main body 11, and it is possible to apply a circular shape or a polygonal shape such as a triangle. In addition, the cross-sectional shape may be a shape that changes in the longitudinal direction of the suture needle 10.

[0029] The suture needle 10 is made of stainless steel, but may be made of other materials such as polymers, alloys, or any other material with suitable rigidity.

[0030] The main body 11 has a circular cross section with a diameter of 0.5 mm at the base end 13, and has a tapered shape with the diameter decreasing toward the tip 12, and has a tapered shape in a range of about 1 mm from the tip 12.

[0031] The base end 13 is provided with a resilient hole (spring hole), which is the portion where a suture (not shown) is attached. The resilient hole is a long, narrow hole with a forked tip, and the suture is attached to the suture needle 10 by pressing the side of the suture against the fork and passing it through the hole. The base end 13 is not limited to a resilient hole (spring hole), but may also be provided with a flat hole (normal hole). Alternatively, a blind hole of a predetermined depth may be formed in the end surface of the base end 13, and the suture may be attached to the suture needle 10 by inserting the suture into this blind hole and crimping the periphery of the base end 13.

[0032] 1(b) shows a schematic side view of the suture needle 10. The section of the main body 11 extending a predetermined length from the tip 12 (P1-P2 in the figure) is a weakly curved section (hereinafter referred to as the "weakly curved section" or "first curved section") 14, and the section extending a predetermined length from the base end 13 (P2-P3 in the figure) is a strongly curved section 15 (hereinafter referred to as the "strongly curved section" or "second curved section").

[0033] In this way, the second curved portion 15 is more strongly curved than the first curved portion 14. In other words, the second curved portion 15 has a greater degree of curvature than the first curved portion 14, and when the shape of the curved portion is circular, the curvature is greater.

[0034] 1(b), the length of the weak curve portion 14 is L1, the length of the strong curve portion 15 is L2, the angle formed by the tangent line at the boundary between the weak curve portion 14 and the strong curve portion 15 and the tangent line at the tip 12 is θ1, and the angle formed by the tangent line at the boundary between the weak curve portion 14 and the strong curve portion 15 and the tangent line at the base end 13 is θ2. In the suture needle 10, L1 = 8.7 mm, L2 = 6.7 mm, θ1 = 58°, and θ2 = 90°.

[0035] <Movement of the suture needle>

[0036] The suturing operation using the suturing needle 10 according to this embodiment will be described with reference to FIG.

[0037] When using the suture needle 10 according to this embodiment, the suture needle 10 to which the suture thread 16 is attached is inserted below the fat 3 or dermis 2 at one wound edge (incision surface) 5, and the suture needle 10 is advanced gently following the curvature of the weak curve 14 (FIGS. 2(a)-(b)). As a result, the suture needle 10 can be easily advanced from the insertion point at the wound edge (incision surface) 5 toward the depth.

[0038] Next, the suture needle 10 is advanced from the insertion point of the wound edge (incision surface) 5, and then the needle holder is rotated to advance the suture needle 10 so that the trajectory is an arc following the curvature of the strong curved portion 15 (FIG. 2(b)). In this way, by following the curvature of the strong curved portion 15, the advancing direction of the suture needle 10 can be changed in a narrow region deep in the tissue from a direction toward the deep tissue to a direction toward the incision surface 5.

[0039] Next, the suture needle 10 is withdrawn from above the dermis 2 or from the epidermis 1 at one of the wound edges (incision surfaces) 5 (FIG. 2(c)).

[0040] Next, the suture needle 10 is inserted into the upper part of the dermis 2 or into the epidermis 1 at the other wound edge (incision surface) 5, and the suture needle 10 is advanced gently toward the deeper part, following the curvature of the weak curve 14 (Fig. 2(d)-(e)).

[0041] Next, the needle holder is rotated so that the trajectory is an arc following the curvature of the strong curve 15, and the suture needle 10 is advanced, and pulled out from below the fat 3 or dermis 2 at the other wound edge (incision surface) 5 (Figure 2(f)).

[0042] Finally, the suture 16 is ligated below the fat 3 or the dermis 2 (FIG. 2(g)). The ligation point 16_2 is shown in the figure.

[0043] An example of a suturing operation using the suturing needle 10 according to this embodiment is shown in Fig. 3. In Fig. 3, the epidermis 1 is not shown in order to simplify the explanation.

[0044] In this suturing, as shown in Fig. 3(a), fat 3 is peeled off and a peeled portion is formed from the incision surface 5. This allows suturing at a longer distance from the wound edge (incision surface) 5.

[0045] First, the suture needle 10 is inserted through the detached portion of the fat 3 at one wound edge (incision surface) 5 (Fig. 3(a)). At this time, the base end of the suture needle 10 is strongly curved, which makes it easy to move and control (insert) the needle in a narrow surgical field.

[0046] Next, the suture needle 10 is advanced inside the tissue (FIGS. 3(b)-(c)). At this time, since the tip side of the suture needle 10 has a slight curve, it can be easily inserted and moved a certain distance or more into the subdermal layer.

[0047] Next, the suture needle 10 is inserted through the dermis 2 at the other wound edge (incision surface) 5 (Fig. 3(d)). At this time, the tip side is slightly curved, so the suture needle 10 can be easily inserted at an appropriate angle. Here, when the tip side is strongly curved as in conventional needles, the wrist must be turned more greatly, but when the tip side is weakly curved as in suture needle 10, the wrist movement can be suppressed and the needle can be easily manipulated.

[0048] Furthermore, if the needle is strongly curved like a conventional needle, the base end of the suture needle 10 may crush the epidermis, but if the tip end is weakly curved like the suture needle 10, crushing of the epidermis can be avoided.

[0049] Next, the suture needle 10 is advanced inside the tissue (FIG. 3(e)). At this time, since the tip side of the suture needle 10 has a slight curve, it can be easily inserted and moved a certain distance or more into the subdermal layer.

[0050] Next, the suture needle 10 is pulled out from the detached portion of the fat 3 at the other wound edge (incision surface) 5 (Fig. 3(f)-(g)). At this time, the base end of the suture needle 10 is strongly curved, so that the suture needle 10 can be easily pulled out in the narrow surgical field.

[0051] Finally, the suture 16 is ligated at the adipose tissue 3 (Figure 3(h)).

[0052] Furthermore, as shown in Figure 4, by similarly suturing the superficial layer of the dermis 2, approximately 1 mm below the epidermis, using the suture needle according to the present invention (16_3 in the figure), the suture can be made firmly and reliably, and the wound edge can be stabilized for a long period of time. In this case, a suture needle smaller than the suture needle described above can be used.

[0053] <Effects of suture needles> The effects of the suture needle 10 according to this embodiment will be described with reference to Fig. 5. For comparison, Figs. 5(a) and (b) show the case where a conventional needle 30 is used. Fig. 5(c) shows the case where the suture needle 10 according to this embodiment is used.

[0054] In dermal sutures, the skin at the suture site is elevated to prevent tension from being applied to the area around the scar while maintaining blood flow to the area around the scar. At this time, it is important to advance the suture needle deep into the tissue during suturing to strengthen the suture site and to evert the epidermis 1 so that it does not turn inward (to prevent inversion).

[0055] When performing dermal sutures using a conventional needle 30, as shown in Figure 5(a), after inserting the suture needle 10 into the tissue from the wound edge (incision surface) 5, the conventional needle 30 is advanced following the curvature of the strong curve, and when the conventional needle 30 is advanced deep into the tissue, the needle is likely to be pulled downward (arrow 37 in the figure) from the tissue. As a result, the epidermis 1 is pulled downward, and there is a risk that the epidermis 1 will turn inward (invert) into the wound.

[0056] Therefore, in order to avoid inversion of the epidermis 1, when performing dermal sutures using conventional needles 30, the skin is pulled upward or diagonally upward (arrow 38 in the figure) as shown in Figure 5(b). As a result, the epidermis 1 is everted rather than inverted, and the skin surface is raised for suturing.

[0057] At this time, the suture track, i.e., the suture shape on the cross section of the skin, tends to have a concave portion at the top (skin surface side), and the protruding shape tends to have a flat portion on the top surface.

[0058] However, if excessive force is applied when pulling the skin upward, it can damage the skin tissue and reduce blood flow around the wound, delaying wound healing and potentially causing necrosis of the wound edge.

[0059] On the other hand, when using the suture needle 10 according to this embodiment, as shown in Figure 5(c), the suture needle 10 is first inserted into the tissue from the incision surface 5, and then the needle is advanced following the curvature of the weakly curved portion 14, so that the needle can be easily advanced toward the depth of the tissue.

[0060] Next, the suture needle 10 is advanced so that its trajectory is an arc, following the curvature of the strongly curved portion 15, and then advanced and withdrawn from the tissue following the curvature of the weakly curved portion 14. As a result, the suture needle 10 can be withdrawn in a substantially horizontal direction, i.e., a direction substantially perpendicular to the incision surface 5 (arrow 17 in the figure).

[0061] Therefore, by suppressing pulling of the skin upward or diagonally upward (arrow 18 in the figure), the epidermis 1 is everted rather than inverted, and the skin surface can be raised for suturing.

[0062] At this time, the suture path, i.e., the shape of the suture on the cross section of the skin, formed by the suture thread, is different from the shape when conventional needles 30 are used, and has a convex Mount Fuji shape on the upper side (skin surface side). Also, the raised shape of the wound edge has a convex shape on the upper side (skin surface side).

[0063] Therefore, damage to skin tissue can be suppressed, blood flow around the scar can be maintained, and wounds can be healed quickly.

[0064] Furthermore, when the weakly curved portion 14 of the suture needle 10 according to this embodiment is replaced with a straight shape, the suture needle is advanced by following the straight shape and then advanced using the strongly curved portion 15, which makes it difficult to perform a stable suturing operation (needle operation) and may result in breakage of the suture needle or damage to the living body due to centrifugal force.

[0065] Furthermore, if the suture needle 10 according to this embodiment has a shape consisting only of the weakly curved portion 14, when the suture needle is advanced deep into the tissue and then advanced toward the tissue surface, the trajectory of the suture needle will be a large arc, making it difficult to advance (maneuver) the needle in a narrow area within the dermis 2.

[0066] On the other hand, the suture needle 10 of this embodiment has not only a weakly curved portion 14 but also a strongly curved portion 15 on the base end side, so that the suture needle can be smoothly pulled out even in a narrow area, making the entire needle movement smoother, ensuring ease of handling, and reducing the strain on the wrist joint movement.

[0067] The suture needle according to this embodiment can secure the point of tension reduction at a greater distance from the surface of the wound edge within the lower dermis, which allows the suture needle to be withdrawn in the upper dermis (a shallower region of the dermis), improving the accuracy of wound edge healing.

[0068] With the suture needle of this embodiment, the weak curve at the tip makes it easy to predict the needle's trajectory, allowing the needle to be accurately driven and sutured through the subdermis or fat at a longer distance from the wound edge (incision surface) 5.

[0069] Furthermore, when first inserting the suture needle into the dermis during suturing, the strain on the wrist can be reduced by holding the vicinity of base end 13 of the suture needle with a needle holder.

[0070] Furthermore, when suturing, after driving the needle into one wound edge (incision surface) 5, the needle can be inserted into the other wound edge (incision surface) 5 by having a weak curved portion 14 on the tip side, allowing the surgeon to drive the needle without dorsiflexing the wrist. As a result, the needle driving action becomes smooth overall, and the risk of damaging the other wound edge (incision surface) 5 with the base end 13 of the suture needle can be reduced.

[0071] In treatment using the suture needle according to this embodiment, the width of the scar after healing can be reduced by improving the tensile strength and the precision of wound edge healing, and the re-formation of hypertrophic scars can be prevented.

[0072] In this embodiment, the suture needle has the above-mentioned shape as an example, but is not limited to this. Figure 6 shows the center line of suture needle 10. When the length of weak curve portion 14 is L1, the length of strong curve portion 15 is L2, the angle between the tangent at tip 12 (P1) of weak curve portion 14 and the tangent at the other end (P2) opposite tip 12 is θ1, and the angle between the tangent at base end 13 (P3) of strong curve portion 15 and the tangent at the other end (P2) opposite base end 13 is θ2, L1 + L2 = 3 to 300 mm, 0° < θ1 ≦ 67.5°, and 67.5° < θ2 ≦ 100° can be satisfied.

[0073] It is also desirable that 53°≦θ1≦63°, 85°≦θ2≦95°, L1+L2=8 mm or more and 15 mm or less, and L1 / (L1+L2)=0.3 or more and 0.7 or less.

[0074] Here, a linear portion may be included at the boundary between the weakly curved portion 14 and the strongly curved portion 15. Also, a linear portion may be included at the tip 12 or the base end 13. The length of the linear portion may be within a range in which the suture needle 10 can achieve the above-mentioned effects.

[0075] In this embodiment, a circular shape is used as the curved shape, but other curved shapes such as an elliptical shape or a quadratic function curve may also be used, as long as the curved shape falls within the range of the hatched area shown in Figure 7 (for example, the solid line in the figure).

[0076] In the operation of the suture needle, the suture needle is advanced by following the degree of curvature of the curved portion (curvature in the case of a circular curved shape).

[0077] <Second embodiment> A suture with a suture needle according to a second embodiment of the present invention will be described with reference to FIG.

[0078] <Configuration of suture with needle> 8 shows a perspective view of a suture thread 20 with a suture needle according to this embodiment. The suture thread 20 with a suture needle according to this embodiment comprises the suture needle 10 according to the first embodiment and a suture thread 21.

[0079] The suture needle 10 has a body 11, a tip 12, and a base end 13. The suture thread 21 is inserted into a blind hole provided in the base end 13 and attached to the suture needle 10 by crimping the periphery of the base end 13. The suture thread 21 may be attached to the suture needle 10 by heat treatment, adhesive, or the like.

[0080] The suture 21 is made of nylon monofilament (single thread) and has a diameter of 0.05 mm. The material of the suture 21 is not limited to this, but it can also be polyester, silk, or braid (knitted thread). The diameter can be 0.001 mm to 0.8 mm. The suture 21 can also be a synthetic absorbable thread, and the material can be monofilament or braid.

[0081] The suture thread with suture needle according to this embodiment has the same effects in suturing as the first embodiment.

[0082] The suture needle in the embodiment of the present invention may be a round needle with a conical tip, a square needle with a triangular pyramidal tip (sharp on the inside of the curve), an inverted triangular needle with a triangular pyramidal tip (sharp on the outside of the curve), a tapered cut needle with a cylindrical shape and only the tip shaped like a triangular pyramid, or a blunt needle with a slightly rounded and blunt tip. The tip may also be an inverted square needle with an inverted triangular cross section, or a spatula-shaped inverted square needle with the tip (apex) removed.

[0083] In the embodiments of the present invention, the length of the suture needle is 4.5 mm or 5 mm, and the needle diameter is 100 μm, but this is not limited to these. The length of the suture needle can range from 1 mm to 100 mm, and the needle diameter can range from 50 μm to 1.5 mm. In particular, for microsurgery such as brain surgery, a length of 3 mm to 7 mm and a needle diameter of 50 μm to 250 μm are desirable. The length of the suture needle is desirable to be 9 mm to 24 mm for vascular suturing, 10 mm to 70 mm for surgical procedures, and 9 mm to 25 mm for plastic surgery.

[0084] The suture needle according to the embodiment of the present invention is manufactured using the usual manufacturing method. For example, after cutting the stainless steel material to a predetermined length, a hole for the suture thread is formed. Next, the tip and main body (body) are processed, including the formation of a curved portion, and then polished and sterilized.

[0085] In the embodiment of the present invention, an example of application to dermal suturing has been shown, but the present invention can also be applied to subcutaneous suturing in surgical operations such as plastic surgery, brain surgery, and digestive surgery.

[0086] In the embodiment of the present invention, examples of the structure, dimensions, materials, etc. of each component in the configuration, operation, etc. of the suture needle and suture thread with suture needle are shown, but the present invention is not limited to these. Anything that can demonstrate the function and effect of the suture needle may be used. [Industrial Applicability]

[0087] INDUSTRIAL APPLICABILITY The present invention has industrial applicability as a suture needle and a suture thread with a suture needle, and as a medical device used in surgical operations such as plastic surgery, brain surgery, and gastrointestinal surgery. [Explanation of symbols]

[0088] 10 suture needle 11 Main unit 12 Tip 13 Proximal end 14 Weak curvature 15 Scleria 16, 21 sutures 20 sutures with needles

Claims

1. A suture needle having a sharp tip and a suture thread attached to a base end, A first curved portion is provided on the distal end side, and a second curved portion is provided on the proximal end side, the first curved portion and the second curved portion are circular, the second curved portion is stronger than the first curved portion; In the second curved portion, an angle formed by a tangent at the base end and a tangent at the other end opposite to the base end is greater than 67.5° and not greater than 100°. A suture needle characterized by:

2. In the first curved portion, an angle formed by a tangent at the tip and a tangent at the other end opposite to the tip is greater than 0° and not more than 67.5°. The suture needle according to claim 1 .

3. The suture needle according to claim 1 or 2; Sutures and A suture with a suture needle comprising:

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