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Advanced Open Surgical Skills »  ATOSS Tasks »  Task 5: Pitch & catch (deep)

Task 5: Continuous Suturing At Depth: Pitch & Catch

Instructional Video


Task Overview


Summary: This task requires 10 continuous sutures at depth using pitch and catch reloading technique.

Equipment: One fine needle holder, one fine forceps, one 5-0 or 6-0 Prolene suture on a C1 cut to 15cm.


Task set-up: Position fabric at the base of the model (lowest platform level) as follows:



Task steps:

  1. Load needle into fine needle holder.
  2. Complete 10 continuous sutures at depth using pitch and catch reloading technique.

Task rules:Take single bites, entering and exiting at blue dots on either side of the slit. Use forceps to stabilize the tissue then grasp the needle. Needle should be re-loaded on the field at the point of exit from the tissue in the iliac fossa model cavity.


Tips & tricks:

  • Load your needle at a 100-150 degree angle.
  • Unlock needle holder before entering tissue; do not lock until needle is fully removed from tissue.
  • Use forceps to stabilize tissue at needle entry and exit.
  • Do not handle the needle tip with forceps (this will cause damage and blunting).
  • Follow the curve of the needle when removing it from tissue, do not torque.
  • Reload needle with hand pronated to be ready for the next bite.

Cutoff time: Maximum time for task completion is 180 seconds. During formal assessment, time will start when the needle makes contact with the tissue for the 1st time and end when the needle is removed from tissue for the last (10th) time. If the task is not completed within the allotted time, you will be asked to stop.


Scoring: A score will be assigned for each micro-skill. Score assignments are based on the following:









Unable to complete task

Completed task w/ major errors

Completed task w/ minor errors

Proficient, no errors, some awkward moves

Expert, no errors, smooth and efficient


Score (1-5)

1. Loading the needle with correct angle


2. Releasing the needle in atraumatic fashion


3. Grasping the needle in the forceps and atraumatic removal of the needle from the tissue


4. Following the curve of the needle


5. Coordinated transfer between of the needle between the forceps and needle holder


6. Reloading the needle in the correct angle for the next stitch


7. Overall Rating


Total (Sum of Scores for All Micro-Skills) [Max = 35]


Scoring Formula: see Task & Scoring Overview or score calculator (access via Google doc or download excel file)

Expert Score: 50

Example Video

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