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. 2011 Jan;7(1):112-5.
doi: 10.4103/0972-9941.72401.

One-handed knot tying technique in single-incision laparoscopic surgery

John Thanakumar  1 , Pravin Hector John
Affiliations

One-handed knot tying technique in single-incision laparoscopic surgery

John Thanakumar et al. J Minim Access Surg. 2011 Jan.

Abstract

In an open surgery, two-handed as well as one-handed knot tying is commonplace. Knot tying in laparoscopic surgery traditionally involves the use of two instruments (for fashioning an intracorporeal knot) or passing of a ligature around a tubular structure, exteriorising it, fashioning a knot, and sliding it down with a knot-pusher (external slip knot). With increasing interest in expanding applications of single-incision laparoscopic surgery (SILS), surgeons are faced with new challenges. In SILS it is not usually possible to utilise two instruments for knot tying as they lie almost parallel. We describe a novel one-handed knot tying technique devised specifically for use in SILS.

Keywords: Knot; single-incision laparoscopic surgery; surgery.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Suture material being passed around the tube
Figure 2
Figure 2
Formation of an ‘O’
Figure 3
Figure 3
Grasper carrying the suture through the ‘O’ to initiate the first half knot
Figure 4
Figure 4
The first half knot is tightened into position
Figure 5
Figure 5
Formation of second ‘O’ by underwrapping.
Figure 6
Figure 6
End of the suture carried through the ‘O’
Figure 7
Figure 7
Completion of the knot by pulling the ends of the suture in opposite directions
See this image and copyright information in PMC

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