Knot Properties of Alternating Sliding Knots with Different Patterns in Comparison to Alternating and Simple Sliding Knots

Knot security in laparoscopic surgery

“…Surgeons are also taught not to cross their hands when tying knots. Not crossing one's hands means that the ends of the strands inevitably leave the knot on the same side from which they entered, thus resulting in a sliding knot [2,3].…”

“…The types of knot most used in surgery and some shown in previous studies to be the most secure were selected for evaluation [2,3,8]. It is very dicult to evaluate every type of knot because there are many variations in technique; nevertheless, the knots used in this study seem to be representative of the most important ones.…”

“…The number of experiments performed for each type of knot is representative because it was established in a previous study that the minimum number of experiments needed is ®ve for each type of knot [4]. In other studies, an average of 5 to 20 experiments for each type of knot were performed [2,4,8,14,18,19].…”

“…The same types of knots were done by laparoscopy, the sliding knots being extracorporeal and the¯at knots intracorporeal. Those knots most used in surgery and proven to be the safest in previous studies were selected for this study [2,3,8]. The material used was braided polyester 2-0 USP (3.0 metric) (Ti-cron, USS, Davis & Geck).…”

“…It has been shown that both the selection of the knot and the selection of the material to be used are determinant factors in suture security [2,3,11,18]. Several studies have evaluated conventional knots, taking different aspects into consideration, such as suture caliber, coverage, material, knot geometry, and the surgeon's technique [2, 3, 7, 16±18].…”