Abstract
Microvascular surgery requires fine finger movements with stabilised hands for successful anastomosis. Limited space in deeper locations, such as the interhemispheric fissure, increases the difficulty in placing the knots during microvascular suturing. This note describes a novel technique of constructing reef knots. The technique reduces the excursions of the instrument tips while knotting. Using this knotting technique in deep microvascular suturing improves the ergonomic ease and stability of knots, while working in deep locations through narrow corridors.
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