THE 4-S MODIFICATION OF THE ROEDER KNOT - HOW TO TIE IT

Background: The 4-S modification of the Roeder knot may be tied laparo scopically as a single-throw knot. Technique: It is tied by adding a f ourth wrap around the suture loop and securing the loop in place with a square knot rather than a single half-hitch. Experience: We have use d this knot in laparoscopic surgeries for more than 2 years and have n ot observed knot slippage. Conclusion: This modification results in a knot comparable in strength to the strongest laparoscopic multiple-thr ow square knots. (C) 1997 by The American College of Obstetricians and Gynecologists.