title: A biomechanical study of laparoscopic 4S-modified Roeder and Weston knot strength in 3-0 polyglactin 910 and 3-0 polydioxanone.
abstract: OBJECTIVE
  To (1) evaluate biomechanical strength of 4 different laparoscopic knots using 2 suture types, and (2) evaluate carotid artery ligature bursting pressure of 2 knots using a single suture type.
  
  
  METHODS
  Biomechanical materials testing.
  
  
  METHODS
  Suture material (3-0 polydioxanone, 3-0 polyglactin 910).
  
  
  METHODS
  Four knot types were tested: 4S-modified Roeder (4SMR) Weston plus 3 square throws (W3S); Weston plus 3 granny throws (W3G); and a 4 square throw knot as a control (control); 24 specimens of each knot type were tied with 3-0 polyglactin 910 and 24 of 3 knot types (4SMR, W3S, control) were tied with 3-0 polydioxanone. Suture loop constructs were tested to 3 mm displacement failure and ultimate failure. Carotid artery ligation bursting pressure was tested using 10 samples each of 4SMR and W3S knots with 3-0 polyglactin 910.
  
  
  RESULTS
  The W3S, W3G, and controls were similar. The 4SMR was similar to W3S using 3-0 PDS but the 4SMR had lower load to failure and greater elongation than the Weston using 3-0 polyglactin 910. The 4SMR had a higher slippage rate with 3-0 polyglactin 910. All ligatures withstood supraphysiologic pressures.
  
  
  CONCLUSIONS
  Surgeons using 3-0 polyglactin 910 should consider using the Weston knot with added throws during laparoscopic procedures.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164-6610, USA.
authors.forename: Russell W
authors.initials: RW
authors.lastname: Fugazzi
authors.forename: Boel A
authors.initials: BA
authors.lastname: Fransson
authors.forename: Katie M
authors.initials: KM
authors.lastname: Curran
authors.forename: Howard M
authors.initials: HM
authors.lastname: Davis
authors.forename: John M
authors.initials: JM
authors.lastname: Gay
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D004285:Dogs / Q000601:surgery*; D059485:Gastropexy / Q000295:instrumentation / Q000662:veterinary*; D016687:Polydioxanone; D011098:Polyglactin 910; D013536:Suture Techniques / Q000295:instrumentation / Q000662:veterinary*; D013537:Sutures / Q000592:standards / Q000662:veterinary*; D013718:Tensile Strength
chemical_list: D016687:Polydioxanone; D011098:Polyglactin 910