World Journal of Laparoscopic Surgery

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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: 01-04-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


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.


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