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ssss1 Needle introduction through a cannula. (A). The suture is grasped with the left‐hand instrument (for the right‐handed surgeon) 2–3 cm from the swaged on end. The needle is then passed through the cannula. The cannula valve may need to be released when introducing to avoid disrupting the needle position. (B). When visible in the field, the right needle driver grasps the needle. The left instrument maintains grasp on the suture until needle position is as desired for the suture bite.

ssss1 Needle position correction. (A). The needle is not perpendicular in the jaw of the needle driver. (B). The left‐hand instrument grasps the suture, and the right hand is releasing the ratchet to loosen up the grasp of the needle without letting go of it. Now the suture can be gently manipulated until the needle is in a more optimal position.

ssss1 Needle introduction through a left‐sided cannula according to Brody et al. [11] (A). The needle is grasped with the left‐hand instrument backloaded (i.e., with the needle tip pointing in toward the shaft of the instrument). The convex part of the needle is positioned at 3 o'clock. (B). The instrument is rotated clockwise 90° so the convexity points toward 6 o'clock. (C). The right needle driver can grasp the needle, one‐third to half the distance from the swaged on end, and the place the suture bite. (D). The needle is well positioned for a right‐to‐left suture bite.