Suturing and knotting techniques for thoracoscopic cardiac surgery

Microvascular anastomosis for endoscopic coronary artery bypass grafting ha s became the latest technique in the evolution of advanced endoscopic surge ry. Although the construction of the anastomosis is a particularly challeng ing technique, adhering to certain principles enables the surgeon to accomp lish this task safely. Topics of critical focus include endoscopic suturing principles and approach, methods for improving efficiency, needle control, and suturing instrumentation. The intracorporeal knot tying technique, usi ng the classic convertible square knot, is described and illustrated.