Laparoscopic Meltzer Slip Knot - Dr. R.K. Mishra

Laparoscopic Meltzer Slip Knot

This modification of the Roeder knot was described in 1991 by Meltzer for use with PDS and has now superseded the use of Roeder's knot. It has components:

•    Two hitches
•    Three winds
•    Two-half locking hitches

Meltzer knot can be remembered as 2:3:2

Tying a Meltzer knot

Step A:    Two-half knot is taken first.

Step B:    Three rounds are taken in front of the first double half knot over both the limb of the loop.

Step C:    Stack the knot and trim the short end. Slide the knot into place with knot pusher under tension.

Steps of Meltzer Slip Knot
Steps of Meltzer Slip Knot


The Meltzer knot is now used by most of the surgeons instead of the Roeder knot to tie the medial end of the cystic duct during cholecystectomy and to fix the cystic duct drainage cannula after trans-cystic clearance of ductal stones, as catgut is no longer available. PDS is the suture material of choice for Meltzer knot.

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