This video titled "Laparoscopic Dundee Jamming Knot: A Reliable Extracorporeal Knotting Technique in Minimal Access Surgery" provides a step-by-step demonstration of one of the most widely used and dependable suturing methods in laparoscopy. The Dundee Jamming Knot, named after the University of Dundee, is an extracorporeal knot designed to offer secure tissue approximation in situations where intracorporeal knot tying may be time-consuming, technically demanding, or anatomically restricted.

What is the Dundee Jamming Knot?

The Dundee Jamming Knot is an extracorporeal sliding knot that combines the benefits of a slip knot with the added security of a locking mechanism. This knot is formed outside the abdominal cavity and then pushed inside using a knot pusher through a 5mm or 10mm port. Once the knot is snugly placed at the target site, it tightens smoothly and locks effectively, reducing the risk of slippage during laparoscopic procedures.

Key Features and Steps Highlighted in the Video

Formation of the initial base loop and locking throws outside the body
Use of a dedicated knot pusher to guide the knot precisely to the site
Final jamming action that locks the knot securely in position
Application on vascular pedicles, mesentery, appendicular stump, and tubal structures

The video demonstrates real-time surgical footage of the knot being used in procedures such as laparoscopic appendectomy, ovarian cystectomy, bowel resection, and tubal ligation, making it an excellent learning resource for beginners and experienced surgeons alike.

Advantages of the Dundee Jamming Knot

Fast and easy to learn, especially for surgeons new to laparoscopic suturing
Minimal risk of knot failure, even under significant tissue tension
Ideal for tight spaces or deep pelvic regions where instrument maneuverability is limited
Cost-effective technique—requires only suture, knot pusher, and standard laparoscopic setup
Versatile across multiple procedures and specialties

Clinical Applications

Laparoscopic Appendectomy – Ligating the base of the appendix securely
Gynecological Surgery – Tubal ligation, ovarian ligament control, or hemostasis
Gastrointestinal Surgery – Securing mesenteric vessels or closing small enterotomies
Pediatric Laparoscopy – Efficient knotting in small operative fields

Safety Tips Shared in the Video

Always test knot security after tightening by applying mild traction
Ensure smooth passage through the trocar to avoid frictional loosening
Avoid excessive force while tightening to prevent tissue tearing
Practice outside the body using simulation models for skill refinement

Conclusion

The Laparoscopic Dundee Jamming Knot is a proven, reliable, and reproducible technique in the hands of laparoscopic surgeons. Its ease of application, knot security, and adaptability make it a staple of extracorporeal suturing in minimal access surgery. This video from World Laparoscopy Hospital serves as a practical guide to mastering this essential knot, equipping you with the confidence to apply it in real surgical settings.

Watch the full video to see the Dundee Jamming Knot in action, learn tips from expert surgeons, and elevate your laparoscopic suturing skills.
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