title: Improved design knot pusher for laparoscopic extracorporeal suturing.
abstract: BACKGROUND
  Reliable instruments are essential for a hassle free laparoscopic operation. We describe a new knot pusher for improved extracorporeal suturing.
  
  
  METHODS
  A new knot pusher was designed and tested in laparoscopic Nissen fundoplication.
  
  
  RESULTS
  The instrument was used satisfactorily in 13 laparoscopic Nissen fundoplications. There were no complications and the instrument was found, overall, to be superior to the commercially available knot pushers.
  
  
  CONCLUSIONS
  The new knot pusher offers a tailored instrument for extracorporeal knot tying.
authors.affiliation: Upper Gastrointestinal Surgical Unit, Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia. wbarto@hotmail.com
authors.forename: Walid
authors.initials: W
authors.lastname: Barto
authors.forename: Stanley
authors.initials: S
authors.lastname: Chen
mesh_terms: D004867:Equipment Design; D018662:Fundoplication / Q000295:instrumentation*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D013536:Suture Techniques / Q000295:instrumentation*