THE TENSIOKNOT INSTRUMENT SET FOR ENDOSCOPIC LIGATION AND SUTURE-KNOTFORMATION AND APPLICATION

In minimally invasive surgery (MIS), intracorporal knot-tying becomes complicated due to the limited field of vision and depth perception. A t the tip of the tensioKNOT instrument, there is a needle driver of 3 mm with a slipfit hollow knot pusher. The knot is extracorporally atta ched by the quick formation of three loops by hand. After intra-abdomi nal insertion, the stitch or ligation is performed under endoscopic vi sion. The knot is pushed onto the standing end of the thread, doubled in an additional loop, and tightened with the integrated knot pusher. This loop allows an increase in the reverse slipping force without tro ublesome instrument change. The feasibility of the instrument set and the strength of the knot were proved in pigs and in 48 cholecystectomi es and hernia repairs in humans. The independent extracorporal formati on of a knot on a second tensioKNOT instrument allows quick applicatio n of a secured slip knot, equivalent to the use of clips and staples. As a result, cost saving is high.