8509 Extracorporeal Knots in Laparoscopy: Modified Roeder's Knot

Abstract

<h3>Study Objective</h3> Advancement in laparoscopic surgery led to the development of various extracorporeal knot tying techniques. In this video, we review types of extracorporeal knots and demonstrate the modified Roeder's knot (MRK) and its' application in total laparoscopic hysterectomy at the time of vaginal vault closure. This instructional video provides a step-by-step approach to the technique of the MRK. <h3>Design</h3> This video abstract uses still images, drawings, video footage and narration to demonstrate the MRK. <h3>Setting</h3> Operating Room, mid-laparoscopic procedure. The patient is in Trendelenburg position, three ancillary ports are used: 2 right-sided ipsilateral ports and a left lower quadrant port. <h3>Patients or Participants</h3> Patients undergoing laparoscopic gynecologic surgery. <h3>Interventions</h3> Application of MRK. <h3>Measurements and Main Results</h3> MRK is a sliding knot, that is formed entirely extracorporeally. The addition of an extra half-hitch to the classic Roeder's knot provides extra knot security. <h3>Conclusion</h3> MRK is safe and feasible for various minimally invasive endoscopic surgeries, especially for suturing tissues under tension. The technique is easy to learn and can be quickly mastered by surgeons and trainees.