THE EFFECT OF KNOT GEOMETRY ON THE STRENGTH OF LAPAROSCOPIC SLIP KNOTS

Citation
Ht. Sharp et al., THE EFFECT OF KNOT GEOMETRY ON THE STRENGTH OF LAPAROSCOPIC SLIP KNOTS, Obstetrics and gynecology, 88(3), 1996, pp. 408-411
Citations number
12
Categorie Soggetti
Obsetric & Gynecology
Journal title
ISSN journal
00297844
Volume
88
Issue
3
Year of publication
1996
Pages
408 - 411
Database
ISI
SICI code
0029-7844(1996)88:3<408:TEOKGO>2.0.ZU;2-G
Abstract
Objective: To evaluate and compare the strength of six different knot geometries used in laparoscopic slip knots. Methods: The strength of s ix extracorporeal slip knots used in laparoscopic surgery was measured using a tensiometer. Two multiple-throw laparoscopic square knots (th e intracorporeal two-turn flat square knot and the extracorporeal slid ing square knot) were used as controls. Each knot type was tied five t imes, and each type was tied in random order by the same primary and a ssisting surgeons using a laparoscopic pelvic surgery training model. One-way analysis of variance was performed to detect significant diffe rences in knot strengths, and the variability in knot strength for eac h knot type was determined by Tukey's multiple comparison. test. Resul ts: A statistically significant effect for knot geometry was identifie d. The mean knot strengths +/- standard deviation (SD), measured in ne wtons, from strongest to weakest, were: 4S knot (28.01 +/- 11.45), fis herman's knot (22.45 +/- 6.89), modified Roeder knot (19.86 +/- 9.30), Roeder knot (15.77 +/- 7.02), Weston knot (7.28 +/- 7.96), and Duncan knot (6.55 +/- 0.95). The mean knot strengths for the multiple-throw control square knots were as follows: intracorporeal two-turn flat squ are knot (41.21 +/- 2.69) and extracorporeal sliding square knot (27.8 1 +/- 16.27). The intracorporeal two-turn flat square knot (control) w as significantly stronger (P < .05) than all slip knots except the 45 and fisherman's knot. Conclusion: The 4S and fisherman's knots are the strongest laparoscopic slip knots and are the only slip knots similar in strength to multiple-throw square knots.