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. 2021 Apr;35(2):216-219.
doi: 10.1080/02688697.2020.1782834. Epub 2020 Jul 1.

Shunt disconnection is less likely using a surgeon's knot compared with a surgical constrictor knot

Mohamed Okasha  1 , Gareth M Dobson  1 , Ioannis Tsonis  1 , Mohammed Hussain  1 , Nicholas Ross  1
Affiliations

Shunt disconnection is less likely using a surgeon's knot compared with a surgical constrictor knot

Mohamed Okasha et al. Br J Neurosurg. 2021 Apr.

Abstract

Introduction: Ventriculo-peritoneal shunt malfunction is a common neurosurgical presentation, which may occur as a result of shunt disconnection at the level of the valve. Previous studies assessing ligatures have suggested that the constrictor knot is stronger in securing a ligature compared to the surgeon's knot. Our study compared the ability of each knot to secure shunt tubing to the valve.

Methods: A medtronic shunt valve was secured to a peritoneal catheter using the surgeon's knot versus constrictor's knot. The weight and subsequent force (N) required to pull off the shunt tubing at the knot site were recorded.

Results: The mean pull-off force was 11.7 N for the surgeon knot, and 8.9 N for the constrictor knot. There was significant difference in favour for the surgeon's knot compared to the constrictor knot.

Conclusions: The surgeon's knot is significantly stronger than the constrictor knot for securing a peritoneal catheter to a CSF shunt valve.

Keywords: Shunt disconnection; constrictor knot; surgeon’s knot.

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