Simple Extracorporeal Knot-Tying Technique in Minimal Access Surgery.

Extracorporeal knot tying is one of the challenges in minimally invasive surgery. The current aids are often associated with mechanical failures and application difficulties, a long learning curve, fraying of sutures, user errors, increased cost, and reduced haptic feedback. We describe a technique that is very conventional and uses a polytetrafluoroethylene pledget to lower the knot. Also, there is no contact between the suture and the instrument at any point, and therefore fraying and tearing of sutures is not an issue. The technique is simple and inexpensive and has an extremely short learning curve.