Surgical knot

Surgical knots (ligatures) are those knots used to bind suture materials together while binding tissue in surgery. They are used in medical and veterinary settings.

Surgical knots are known since the first century when it was described by Greek physician Heraklas in a monograph on surgical knots and slings. In the past, the training of astronauts has included the tying of surgical knots.

The effective tying of surgical knots is a critical skill for surgeons since if the knot does not stay intact, the consequences may be serious such as after pulmonary resection, laparoscopic cholecystectomy, and hysterectomy. Primary, the goal of surgical knot tying is to allow the capacity of a knot (or ligature) to be tightened and remain tight. Ligatures are locked and finished multiple overhand knots. Nevertheless, slipping sometimes happens before the addition of the final knot, particularly during an instrument tie.

The constrictor knot is the knot most used for binding. The constrictor knot closely resembles the clove hitch except the two ends form an overhand knot under the overriding turn. New knots have been described. Other commonly employed knots are: surgeon's knot, modified surgeon's knot, single-double other side knot, strangle knot and modified miller’s knot. The Surgeon's knot has been a standard ligature but in one study it demonstrated slippage. While the suture is being put in place a knot is used to secure the suture. Tying the knot may be done inside the body or outside the body. Of these two options knot tying inside the body takes some time to learn because the surgeon is required to use laparoscopic instrumentation rather than his fingers to loop the suture. Tying the knot outside the body is more simple for most surgeons because the suture is looped with fingers as in traditional tying. Each knot formed has to be guided through a laparoscopic cannula and made tight with a knot-pusher to create the knot.

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