Journal of Minimal Access Surgery

ORIGINAL ARTICLE
[View FULLTEXT] [Download PDF]
Year : 2015  |  Volume : 11  |  Issue : 4  |  Page : 241--245

Towards a better knot: Using mechanics methods to evaluate three knot-tying techniques in laparo-endoscopic single-site surgery

An An Xu, Jiang Fan Zhu, Yuantao Su 
 Department of Minimally Invasive Surgery, East Hospital, Tongji University, School of Medicine, Shanghai 200120, China

Correspondence Address:
Jiang Fan Zhu
Department of Minimally Invasive Surgery, East Hospital, Tongji University, School of Medicine, Shanghai 200120
China

Introduction: Knot tying is difficult but important for laparo-endoscopic single-site surgery (LESS). There are several techniques for LESS knot-tying. However, objective assessment of these skills has not yet been established. The aim of this study was to assess three different knot-tying techniques in LESS using mechanical methods. Materials and Methods: The subject tied 24 knots, eight knots with each of the three techniques in an inanimate box laparoscopic trainer while the movements of their instruments were evaluated using a LESS mechanical evaluation platform. The operations were assessed on the basis of the time, average load of the dominant hand. Then, forces caused the knots to rupture were measured using a material testing system and used to compare the knots«SQ»s strength. Results: The intracorporeal one-hand knot-tying technique presented significantly better time and average load scores than the extracorporeal knot-tying technique (P < 0.01), and the intracorporeal «DQ»side winding«DQ» technique was more time and average load consuming in comparison to other techniques during the performance of knot-tying (P < 0.01). The intracorporeal one-handed knot-tying knots can tolerate better distraction forces compared with the intracorporeal «DQ»side winding«DQ» knot-tying knots and the extracorporeal knot-tying knots (P < 0.05). Conclusions: The intracorporeal one-hand knot-tying technique and knots showed better results than the intracorporeal «DQ»side winding«DQ» technique and the extracorporeal knot-tying technique in terms of the time, average load taken and the force caused the knot to rupture.


How to cite this article:
Xu AA, Zhu JF, Su Y. Towards a better knot: Using mechanics methods to evaluate three knot-tying techniques in laparo-endoscopic single-site surgery.J Min Access Surg 2015;11:241-245


How to cite this URL:
Xu AA, Zhu JF, Su Y. Towards a better knot: Using mechanics methods to evaluate three knot-tying techniques in laparo-endoscopic single-site surgery. J Min Access Surg [serial online] 2015 [cited 2020 Feb 24 ];11:241-245
Available from: http://www.journalofmas.com/article.asp?issn=0972-9941;year=2015;volume=11;issue=4;spage=241;epage=245;aulast=Xu;type=0