World Journal of Laparoscopic Surgery

Register      Login

VOLUME 7 , ISSUE 1 ( January-April, 2014 ) > List of Articles

REVIEW ARTICLE

Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities

Rasaq Akintunde Akindele, Adeniyi Olanipekun Fasanu, Suresh Chandra Mondal, Johnson Olusanmi Komolafe, Rajneesh Kumar Mishra

Citation Information : Akindele RA, Fasanu AO, Mondal SC, Komolafe JO, Mishra RK. Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities. World J Lap Surg 2014; 7 (1):28-32.

DOI: 10.5005/jp-journals-10033-1213

Published Online: 01-12-2016

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Background

Laparoscopic knot tying is a basic surgical skill that has been practiced for centuries having their roots in fishing and sailing.1-4 The advent of endoscopic surgery placed more challenges on the surgeons and this ever growing skills need to be acquired. Since endoscopic and arthroscopic knots must be delivered over a distance to a tissue with minimal access maintaining tension is more important than the knot configuration chosen.5,6 The aim of this article review is to determine which hand tied knot configuration and possibly, suture size, and suture type that would be safe in laparoscopic surgery.

Materials and methods

A literature review was performed using Pubmed, Springerlink, Highwire press and search engines, like Google and Yahoo. The following search terms were used: extracorporeal knot, arthroscopic knots, Roeder's knot, Meltzer's knot, Mishra's knot, Duncan knot, Nicky's knot, SMC knot, Weston knot and Tennessee extracorporeal knot. A total of 48,100 citations were found. Selected papers were screened for further references. Publications that featured illustrations of sliding knots with statistical methods of analysis were selected. More than 20 different sliding knots were used for this review.

Result

Eighty-one articles were reviewed. Most studies have evaluated knot security only and few studies have evaluated simultaneous both loop and knot security and also only a few compared knot and loop securities to the type of suture materials and their sizes. The addition of three RHAPs improves knot security of all sliding knots tested and improves the loop security of most of the sliding knots tested.

Conclusion

The safety of extracorporeal knot depends on knot configuration, especially when further RHAPs are included.

How to cite this article

Akindele RA, Fasanu AO, Mondal SC, Komolafe JO, Mishra RK. Comparing Extracorporeal Knots in Laparoscopy using Knot and Loop Securities. World J Lap Surg 2014;7(1):28-32.


PDF Share
  1. Tissue puncher and loop ligation, new ideas for surgical therapeutic pelvioscopy (laparoscopy) endoscopic intra-abdominal surgery. Endoscopy 1978;10:119-124.
  2. Technique of transanal endoscopic microsurgery. Surg Endoscopy 1988;2:71-75
  3. Knot security in simple sliding knots and its relationship to rotator cuff repair: how secure must the knot be? Arthroscopy 2000;16:202-207.
  4. The book of practical fishing knots. Mechanicsburg, PA: Stackpole Books; 2003.
  5. Loop security as a determinant of tissue fixation security. Arthroscopy 1998;14:773-776.
  6. Minimum number of throws needed for knot security. J Surg Educ 2011;68(2):130-133.
  7. Textbook of practical laparoscopic surgery. Jaypee Brothers Medical Publishers Pvt Ltd, New Delhi 2007;p.104-123.
  8. Mastery of endoscopic and laparoscopic surgery. 2nd ed. Lippincott Williams, Wilkins. 2004.
  9. Available at: http://www.jiaps.com
  10. Haptics in minimally invasive surgery: a review. Minimally Invasive Therapy 2008;17(1):3-16.
  11. Laparoscopy-to-laparotomy quotient in obstetrics and gynecology residency programs. Arch Gyn Obs 2010;283(5):1027-1031.
  12. Knot security in simple sliding knots and its relationship to rotator cuff repair: how secure must the knot be? Arthroscopy 2000;16:202-207.
  13. How capsizing, flipping and flyping of traditional knots can result in new endoscopic knots: a geometric review. J Am Coll Surg 2007;205(5):717-723.
  14. Current concepts: arthroscopic knot tying. Arthroscopy 1999;15:515-521.
  15. A new clinch knot. Obstet Gynecol 1991;78:144-147.
  16. The SMC knot: a new slip knot with locking mechanism. Arthroscopy 2000;16:563-565.
  17. Arthroscopic knot tying. In: McGinty J, Burkhart S, Jackson R, et al, editors. Operative arthroscopy. Philadelphia: Lippincott, Williams and Wilkins, 2004. In press.
  18. Failure characteristics of various arthroscopically tied knots. Clin Orthop Relat Res 2003;408:311-318.
  19. Intracorporeal knot-tying and suturing techniques in laparoscopic surgery: technical details. JSLS 2000;4:17-22.
  20. Simple, instrument-assisted technique for tying a slip knot: a note of caution. ANZJ Surg 2004;74:270-271.
  21. Cyclic testing of arthroscopic knot security. Arthroscopy 2004;20:62-68.
  22. Comprehensive laparoscopic Surgery. Sagar, india 2007;p.40-51.
  23. A comparison of knot security of commonly used hand-tied laparoscopic slipknots. Vet Surg 2004;33(5):521-524.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.