Knot security in laparoscopic surgery. A comparative study with conventional knots.
BACKGROUND
Few comparative studies have evaluated conventional and laparoscopic knots. The objective of this study was to evaluate laparoscopic knot reliability and identify which type of knot is most secure.


METHODS
Seven types of knots were compared; each one was conventionally tied with four and six throws and similarly by laparoscopy. Dinsmore nomenclature for knots was used. A tension meter was used to evaluate knot reliability, using the loop method, and percentage of failure by slipping and tensile strength was calculated for each group.


RESULTS
When S=S=S=S and S=S=S=S=S=S geometry are excluded, there was no difference between laparoscopic and conventional knot. A significant difference between four- and six-throw knots was shown. Excluding S=S=S=S=S=S geometry, all knots in the conventional six-throw group were secure. Intracorporeal 2X1X1X1X1 and 1X1X1X1X1X1 and extracorporeal SXS#SXS#SXS six-throw laparoscopic group knots were secure.


CONCLUSIONS
Laparoscopic knots are as secure as conventional knots. All knots must be made with six throws because security is maximized.
Amortegui
J D
JD
Department of General Surgery, Pontificia Bolivariana University School of Medicine, Cl 78B # 72 A-109, Oficina Postgrados, Medellin, Colombia, South America. joseamortegui@yahoo.com
Restrepo
H
H
D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D013536:Suture Techniques / Q000009:adverse effects / Q000145:classification / Q000592:standards*