Alumi Laparoscopic Discussion Board

Choice of Laparoscopic Knot
Discussion in 'All Categories' started by Ebrahim Mansoor - Aug 19th, 2016 2:07 pm.
Ebrahim Mansoor
Ebrahim Mansoor
Dear Dr Mishra

Please can you provide guidance on the optimal means to apply laparoscopic knots for general surgical application: Please mention the following -

1. intra or extracorporeal choice
2. choice of suture material
3. type of knot

Common instances may include appendix base, bowel repair, cystic duct, cystic artery, splenic pedicle or diaphragm repair. Please mention any other you may think are relevant as well. I cannot find the above answer clearly tabulated in any book or journal article.

Thanking you in advance, EM
re: Choice of Laparoscopic Knot by Dr R K Mishra - Aug 21st, 2016 7:32 am
#1
Dr R K Mishra
Dr R K Mishra
Dear Dr Ebrahim Mansoor

Your question is very big but I am summarizing below:

Choice of suture material in laparoscopic and robotic surgery.

Cholecystectomy Cystic Pedicle.
(Monocryl®) or PDS (1-0) – Extracorporeal ROEDER, MELTZER OR PRETZEL or Mishra's Knot.

Laparoscopic or Robotic Appendectomy.
(Monocryl®) or PDS (2-0) – Extracorporeal ROEDER, MELTZER OR PRETZEL Knot or MISHRA’S Knot.

Laparoscopic or Robotic Myomectomy Intramural layer.
(Monocryl®) or PDS (1-0) – Extracorporeal MELTZER OR SQUARE Knot.
ViCryl (1-0) – Extracorporeal MELTZER OR SQUARE Knot.

Laparoscopic or Robotic Myomectomy Sub Serous layer.
Vicryl (2-0) – Intracorporeal Dundee Jamming Knot, Continuous suturing and Aberdeen Termination.

Laparoscopic or Robotic Tubal Recanalization.
Vicryl (6-0) – Intracorporeal Surgeon’s Knot. Proline (6-0) – Intracorporeal Surgeon’s Knot.

Laparoscopic or Robotic Ureteric Recanalization.
Vicryl (4-0) – Intracorporeal Surgeon’s Knot. (Monocryl®) or PDS (4-0) – Intracorporeal Surgeon’s Knot.

Laparoscopic or Robotic Vaginal Vault Closure.
(Monocryl®) or PDS (2-0) – Extracorporeal Square Knot or Weston Knot.

Duodenal Perforation Surgeon’s knot or Tumble Square Knot
Intracorporeal Surgeon’s Knot or Tumble Square Knot.

Laparoscopic or Robotic Peritoneal Repair of Hernia.
Vicryl (3-0) – Intracorporeal Dundee Jamming Knot Continuous suturing and Aberdeen Termination.
(Monocryl®) or PDS (3-0) – Intracorporeal Dundee Jamming Knot Continuous suturing and Aberdeen Termination.

Laparoscopic or Robotic Bladder Perforation Repair including repair of Vesicovaginal Fistula
Vicryl (2-0) – Intracorporeal Surgeons Knot or Dundee Jamming Knot Continuous suturing and Aberdeen Termination. (Monocryl®) or PDS (2-0) – Intracorporeal Surgeons Knot Dundee Jamming Knot Continuous suturing and Aberdeen Termination.

Laparoscopic or Robotic Intestinal Anastomosis.
Vicryl (3-0) – Intracorporeal Surgeons Knot. (Monocryl®) or PDS (3-0) – Intracorporeal Surgeons Knot

Laparoscopic or Robotic Anastomosis of vascular grafts for vascular access.
GORE-TEX® Suture (3-0) – Intracorporeal Surgeons Knot. Vicryl (3-0) – Intracorporeal Surgeons Knot

Laparoscopic or Robotic Sacrocolpopexy To fix the mesh to sacral promontry.
GORE-TEX® Suture (1-0) – Extracorporeal Square Knot or Tayside knot. Silk Suture (1-0) – Extracorporeal Square Knot or Tayside Knot.

Laparoscopic or Robotic Crural Approximation in Fundoplication.
GORE-TEX® Suture (1-0) – Extracorporeal square knot. Intracorporeal Tumble Square Knot, Surgeons Knot or Weston knot. Silk Suture (1-0) – Extracorporeal Intracorporeal Tumble Square Knot, Surgeons Knot or Weston knot.

Laparoscopic or Robotic Burch Suspension.
GORE-TEX® Suture (1-0) – Extracorporeal Square Knot or Weston Knot or Tumble Square Knot
Silk Suture (1-0) – Extracorporeal Square Knot or Weston Knot or Tumble Square Knot.

Uterine artery ligation, Spllenic artery or Renal Artery.
(Monocryl®) or PDS (1-0) – Extracorporeal ROEDER, MELTZER OR PRETZEL or Mishra's Knot.

re: Choice of Laparoscopic Knot by Dr Amanda - Sep 9th, 2016 7:41 am
#2
Dr Amanda
Dr Amanda
In my opinion learning following knot is sufficient for most of the surgery.

1. Mishra's Knot
2. Square Knot
3. Tumble Square Knot
4. Dundee Jamming Knot
5. Aberdeen Knot
5. Weston Knot
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