2155 Romeo's Gladiator Rule - an Easy and Reproducible Knot Tying Technique

Abstract

Video Objective Describe an easy and reproducible laparoscopic knot tying technique. Setting Laparoscopic suturing is a milestone in endoscopic education and formation. Bidimensional vision impairs the ability of the surgeon to sense the depth and the topographical localization of structures. This characteristic inverts training steps when compared to laparotomy, making suture teaching an independent and advanced topic, when it must be considered a basic feature and a starting point of any surgery. There is a lack of theories and systematic explanations about this topic, turning its apprenticeship a matter of intuition. This reality is reflected in the recent demand for suture courses in the last AAGL congress. Interventions We describe, step-by-step, concepts which make laparoscopic suturing easy when the steps are respected. Concepts as home base, horizon line and Romeo's gladiator movements, help surgeons to overcome the difficulty of laparoscopic suturing, enabling them to perform secure and safe knots. Conclusion Suturing, besides of being a basic feature of any kind of surgery, is considered an advanced topic when dealing to laparoscopic surgery. Romeo's gladiator rule permits overcome the difficulty of laparoscopic suturing, making it feasible to any surgeon with a little training.