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The keys to the new laparoscopic world

Thumbs up! knot and Tornado knot

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Abstract

Most laparoscopic surgeons feel some anxiety when performing intracorporeal knotting with conventional techniques [1, 2]. Two factors contribute to this anxiety. The first is the necessity of recognizing three dimensions on a two-dimensional monitor. The conventional intracorporeal knotting techniques make loops by twisting the thread with a second pair of forceps. This necessitates cooperative movement of both hands, with the added difficulties of depth perception. Regular touch confirmations reduce problems with depth perception. However, touch confirmation is more complicated in laparoscopic surgery than in laparotomy. The second problem is that tied loops can come loose and escape the instruments, especially with hard thread. This is not only stressful but also increases operation time.

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References

  1. A Cuschieri Z Szabo (1995) Tissue approximation in endoscopic surgery: suturing and knotting techniques Isis Medical Media Oxford 167–168

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  2. DL Murphy (1995) ArticleTitleEndoscopic knot tying made easier Aust N Z J Surg 65 507–509 Occurrence Handle7611973

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Authors and Affiliations

  1. Department of surgery, Takanobashi Central Hospital, 2-4-16, Kokutaiji, Naka-ku, Hiroshima, 730-0042, Japan

    K. Uchida & N. Haruta

  2. Department of Surgery, Division of Frontier Medical Science Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

    M. Okajima

  3. Division of Digestive Surgery, Nihon University School of Medicine, 30-1, Ohyaguchi kamimachi, itabashi-ku , Tokyo, 173-8610, Japan

    M. Matsuda

  4. Asachi Kyosai Hospital, 1-36-8, Yanagihara, Adachi-ku, Tokyo, 120-0022, Japan

    M. Yamamoto

Authors
  1. K. Uchida
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  2. N. Haruta
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  3. M. Okajima
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  4. M. Matsuda
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  5. M. Yamamoto
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Corresponding author

Correspondence to K. Uchida.

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Uchida, K., Haruta, N., Okajima, M. et al. The keys to the new laparoscopic world. Surg Endosc 19, 859 (2005). https://doi.org/10.1007/s00464-004-6007-5

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  • DOI: https://doi.org/10.1007/s00464-004-6007-5

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