title: Slip-Knot-Loop Suture for Continuous Suturing in Laparoscopy.
abstract: OBJECTIVE
  One of the challenges of laparoscopic surgery is the time required to perform intracorporeal knots. This can result in considerably longer operating times when compared with the open approach. An example of this is pediatric laparoscopic pyeloplasty, where extensive laparoscopic suturing is required. To reduce the time suturing, the authors developed a new knotting technique for laparoscopic suturing.
  
  
  METHODS
  The authors modified a neurosurgical knot technique to speed up intricate continuous suturing, and a simple slip-knot-loop suture was created. Twenty continuous sutures were performed with five "bites" of tissue each. Ten were performed with a conventional intracorporeal knot to anchor the suture (Group 1), and 10 were performed using the slip-knot-looped suture to anchor (Group 2). This new knotting technique was used to perform five bowel anastomoses on pig intestine and tested for leaks by distending them with saline for 5 minutes.
  
  
  RESULTS
  The mean time to perform the suture for Group 1 was 300 seconds, and the mean time for Group 2 was 236 seconds. Unpaired two-tailed Student's t test comparing the means was significant (P < .001). No leaks occurred in any of the five anastomoses.
  
  
  CONCLUSIONS
  This new slip-knot-loop technique modified for pyeloplasty was easy to use, was quicker than conventional knot tying, and produced safe knots and leak-free anastomoses. This knot is transferable to any laparoscopic procedure where continuous suturing is to be used.
authors.affiliation: Department of Paediatric Surgery and Paediatric Urology, Oxford Children's Hospital, John Radcliffe Hospital , Oxford, United Kingdom .
authors.forename: Gregory
authors.initials: G
authors.lastname: Shepherd
authors.affiliation: Department of Paediatric Surgery and Paediatric Urology, Oxford Children's Hospital, John Radcliffe Hospital , Oxford, United Kingdom .
authors.forename: Rosa
authors.initials: R
authors.lastname: Romero
authors.affiliation: Department of Paediatric Surgery and Paediatric Urology, Oxford Children's Hospital, John Radcliffe Hospital , Oxford, United Kingdom .
authors.forename: Hugh
authors.initials: H
authors.lastname: Grant
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D057868:Anastomotic Leak / Q000175:diagnosis / Q000517:prevention & control; D000818:Animals; D007422:Intestines / Q000601:surgery*; D010535:Laparoscopy; D061646:Operative Time; D013536:Suture Techniques; D013552:Swine