KNOT TYING MANUAL [Ethicon] on *FREE* shipping on qualifying offers. VERY INFORMATIVE BOOK. Hook for superficial ties. The KNOT TYING MANUAL and practice board are available from ETHICON, INC., for all learners of suturing and knot-tying techniques. Suture knot tying manual from Ethicon. Ethicon has produced a very useful guide to different recommended knot tying techniques. Click here to read or.

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Other suture knotting and tying apparatus are described in U. The knotting guide 12 includes a base 16 and a cover 18where the cover may be removably placed over a plurality of pins 20 projecting upwardly from a surface 22 of the base DE DED1 en Such procedures are described ethidon U.

The knotting guide 70 can be adapted to carrying mnual pairs of snare cords, as illustrated knott FIG. The shaft will then be positioned so that it may be pushed or otherwise advanced against the knot to move the knot to a desired location and thereafter tighten the knot.

Usually, for the sliding surgeon’s janual shown in FIGS. A variety of other patterns will also be possible. In this way, the knot pattern which was initially embodied in the snare cords is transferred to the suture ends.

The fastest and easiest method, in our opinion, consists in holding the needle with its concavity bent downwards Figure 1 a or, better still, toward the operating surgeon Figure 1 b. If, at the end of the suture, the thread were too short to accomplish one of the described procedures, it would be possible to use clips better if they are made from absorbable materialor, after performing a knot with tyiing second thread near the final part of the suture, it would be possible to tie together the terminal end of the first suture and one of the two ends of the thread that had just been tied.

This article has been cited by other articles in PMC. It is also possible, as in the first case described above, to insert the needle holder inside the loop in order to spare a phase in performing the initial knot of the suture: The initial and final knot of a laparoscopic continuous suture can be accomplished in several ways and with easy technical solutions that are fully illustrated in the present study. The pins 20 are present to hold the snare cords 30 and 32 in their pre-formed or pre-tied configuration and to facilitate pulling the snare coids 30 and 32 through the knotting guide 12 during the suture exchange step which is described below.


We firmly believe that the knowledge of suturing techniques in laparoscopic surgery must be open to every surgeon who wants to follow this minimally invasive approach. The guide posts 7476and 78 are relatively large and have slightly different shapes, and a first snare cord 80 and a second snare cord 82 are threaded over the guide posts as shown.

Intracorporeal Knot-Tying and Suturing Techniques in Laparoscopic Surgery: Technical Details

A plurality of pins are provided on the base to form paths which tyinb define the partial knot pattern and the complementary knot pattern. More particularly, the present invention relates to methods, devices, and kits for tying knots in suture used in surgical procedures. The suture may be placed at a tissue site by any conventional technique.

An ethidon method to accomplish a preformed loop, as quick hying as safe as the other methods, is the following: Tissue retention spool for intraluminal anastomotic surgical stapling instrument and methods.

Free suture end will then pass through a lower segment of the shaft while suture end passes out a side of the guideas best shown in FIG. The package will be sealed to maintain the sterility of the device To avoid this loop getting loose during its passage through the trocar, it is advisable, in this case, also, to introduce the suture inserting the rod of the needle holder into the loop, as has been previously illustrated.

Fundamental elements are the easiness and rapidity of execution, the tightness of the knot and its possibility of reproduction. Usually, however, some structure, such as a handle, grip, or the like, will be provided on the pull end to facilitate manual pulling and exchange. In an exemplary embodiment, the knotting guide comprises a base and a tyinng cover.

For forming a sliding surgeon’s knot in suture, as illustrated in FIG.

US6171317B1 – Knot tying device and method – Google Patents

Since with this type of loop the knot slides on the suture thread, it is better to adopt another safety measure in order to avoid the loop’s getting loose or tightening during its passage through the trocar, especially if the latter is furnished with a universal valve.

The devices and methods should be easy to use, even in a surgical environment where the suture to be tied may be covered with blood, tissue debris, and other substances which would render tying difficult.


The principles of the present invention call be applied to a wide variety of surgical knots, including in addition to the sliding surgeon’s knot described above, square knots, capstan knots as described in U.

A particularly preferred use of the present invention will be to tie the free ends of a length of suture which has been placed to close a penetration in a blood vessel located at the end of a tissue tract. Such blood vessel penetrations are formed, for example, to provide access to the femoral artery in the groin by the Seldinger technique. Device for closing an opening in tissue and method of closing a tissue opening using the device.

Thus, four or more separate snare cord pairs can be mounted on a single knotting guide 70 using the three separation plates, and illustrated in FIG. What is claimed is: A method for tying a first suture end and a second suture end into a knot, said method comprising:.

Special threads, metal clips, or clips made from reabsorbable material cannot substitute traditional sutures or ligations in every situation. While the above is a complete description of the preferred embodiments of the invention, various alternatives, modifications, and equivalents may be used. US USB1 en Comparative study of the holding strength of slipknots using absobable and nonabsorbable ligature materials.

At present, most suture knots used in surgical procedures are tied completely by hand, particularly in open surgical procedures where a surgeon has free access to the tissue site to be surgically closed. A knot tying device comprises a knotting guide which carries a pair of snare cords.

Suture knot tying manual by Ethicon. Suture Online.

Author information Copyright and License information Disclaimer. A method as in claim 15wherein the complete knot comprises a square knot. Pull tabs and are further provided to draw the snare cords andrespectively, through the knotting guide This generates a new loop d, through which the distal end of the suture a is pushed Figure 6 c.

Every laparoscopic surgeon must absolutely learn these techniques. Open in a separate window. Therapeutic laparoscopic suturing techniques. Finally, medical companies have created several suture materials.