Accuracy of suture placement

Three groups of seven surgeons were each randomly selected from three larger groups with surgical experience of less than 1, 6-10 and 16-20 years. Each surgeon was asked to aim a needle at an exit point using two methods: 'jiggling' (readjustment of the needle in aiming at the target) allowed and jiggling not allowed. The results were not as precise as expected. An improvement from group 1 to group 2 was noticed in both methods (P less than 0.01), but from group 2 to 3 there was improvement only in the method where jiggling was allowed (P less than 0.01). All groups showed a tendency to overshoot the target (P less than 0.01): a shift towards the surgeon in group 1 (P less than 0.05) and towards the opposite side in groups 2 (P less than 0.01) and 3 (P less than 0.05). Jiggling significantly reduced the inaccuracy, and it was concluded that pinpoint accuracy improved with surgical experience. However, the experienced surgeons improve their accuracy by jiggling, with the potential danger of tissue damage by needle adjustment.