KNOT TYING MANUAL [Ethicon] on *FREE* shipping on qualifying offers. VERY INFORMATIVE BOOK. Hook for superficial ties. The KNOT TYING MANUAL and practice board are available from ETHICON, INC., for all learners of suturing and knot-tying techniques. Suture knot tying manual from Ethicon. Ethicon has produced a very useful guide to different recommended knot tying techniques. Click here to read or.

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Laparoscopic choledochotomy with primary closure. A knot tying device as in claim 8wherein the pull end of each kknot cord comprises a handle to permit manual grasping thereof. Apparatuses and methods for formation and use of a slipknot as a surgical suture knot. A plurality of pins are provided on the base to form paths which can define the partial knot pattern and the complementary knot pattern. A preferred use, as mentioned above, is in the suturing of subcutaneous blood vessel puncture sites, such as those formed when accessing a femoral artery in the groin.

This process generates a new loop in the already existing one, which is tied guiding the needle holder through the loop and applying countertraction between the needle holder and the assistant needle holder.

More particularly, the present invention relates ethiicon methods, devices, and kits for tying knots in suture used in surgical procedures. Knpt devices, kits, and methods of the present invention can be used during a wide variety of different surgical procedures. A knot tying device as in claim 8wherein the capture end of each snare cord comprises a loop for receiving a suture end therethrough.

If, at the end of the suture, the thread were too short to accomplish one of the described procedures, it would be possible to use clips better if they are made from absorbable materialor, after performing a knot with a second thread near the final part of the suture, it would be possible to tie together the terminal end of the first suture and one of the two ends of the thread that had just been tied.

Adequate experience is reached by practicing for a long time on the simulator, before performing any operation in which these techniques are necessary.

US6171317B1 – Knot tying device and method – Google Patents

The exact pattern of the pins 20 will be selected based on the type of knot which will be embodied in the snare cord and subsequently transferred into the suture ends. The shaft will then be positioned so that it may be pushed or otherwise advanced against the knot to move the knot to a desired location and thereafter tighten the knot. Other exemplary suturing procedures include forming an anastomoses between blood vessels, including end-to-end anastomoses, end-to-side anastomoses, and side-to-side anastomoses; suturing prosthetic devices, such as artificial heart valves, into place; forming knots in sutures which have been placed using laparoscopic and other minimally invasive procedures; endoscopic surgery; and the like.


It will be appreciated that the knot pattern formed in the two snare cords has an identical configuration to the sliding surgeon’s knot which is eventually to be formed in the suture ends. Therefore, the above description should not be taken as limiting the scope of the invention which is defined by the appended claims. In an exemplary embodiment, the knotting guide comprises a base and a removable cover. The initial and final knot of a laparoscopic continuous suture can be accomplished in several ways and with easy technical solutions that are fully illustrated in the present study.

Year of fee payment: A method as in claim 16 sthicon, wherein the single length of suture passes through penetrations on the periphery of a blood vessel puncture. Pulling the distal end of suture a, the etuicon is tied generating a slipknot. A method as in claim 15wherein the complete knot comprises a sliding knot having a rail end and a cinching end, wherein the knot is advanced by holding the rail end and pushing the knot.

Comparative study of the holding strength of slipknots using absobable and nonabsorbable ligature materials. This material associates the advantages of an intertwined suture better tightness of the knot, high tension strength, quick absorption, lack of memory with the peculiar features of a monofilament greater smoothness, lack of capillarity, higher inertial force and minor trauma of the tissues. US USB1 en Preferably, the knotting device will have the preferred structure described above.

The pull end of the snare etjicon can be unmodified, i. Such knotting devices knor integral knot pushers will be particularly useful with the preferred sliding surgeon’s knots, where one end of the suture can be manually grasped while the knot is slid in a distal maual away from the end which is being inot. A knot tying device as in claim 8wherein the pins are arranged in a pattern having a cluster of four pins at one end and a line of at least three pins extending from the cluster.

Other more complex structures, including wire eyelets, clips, and the like, could also be used. Since with this type of loop the knot slides on the suture thread, it is better to adopt another safety measure in order to avoid the loop’s getting loose or tightening during its passage through the trocar, especially knlt the latter is furnished with a universal valve.

Endoscopic suturing and knot tying manual.

Intracorporeal Knot-Tying and Suturing Techniques in Laparoscopic Surgery: Technical Details

A knot tying device as in claim 1wherein the knotting guide comprises a base and a cover that can be opened to release a knot formed in the suture ends after exchange with the snare cords.


Field of the Invention The present invention relates generally to medical apparatus and methods. Each snare cord comprises a suture capture end and a pull end. A variety of knot tying apparatus have been proposed for use in instances where the surgeon does not have direct access, such as laparoscopic and other minimally invasive procedures.

While in the first loop the distal end of the suture is pushed underneath, in the second one it must be pulled through the front, and vice versa. A knotting device comprising:. To tie the knot, the needle holder drops the needle and grasps the thread close to the suture in order to close it well.

A knot tying device as in claim 2wherein the knotting guide further comprises pins between the base and the cover, wherein the snare cords are arranged about the pins in the loose knot pattern.

A knot tying device comprising:. A method as in claim 22wherein the two pulling steps are performed sequentially. More usually, however, the snare cords will be distinguished based on indicia present on the device itself.

USB1 – Knot tying device and method – Google Patents

Preferred cord materials include polyester, nylon, and polypropylene. Additionally, the use of channels, cleats, eye holes, and a variety of other mechanical structures for defining the cord paths could also be employed.

Pull tabs and are further provided to draw the snare cords andrespectively, through the knotting guide Finally, the end of the suture is guided with the needle through the last generated loop, and, using retraction, the final tightening of the knot is performed. At least some of these objectives will be met by the invention described hereinafter. For example, the first cord 30 may be formed over the pins with a capture end 34 e.

A method as in claim 15wherein the first suture end and the second suture end comprise opposite ends of a single length of suture. A method for tying and advancing a knot to a surgical site, said method comprising:. A method as in claim 16wherein the single length of suture passes between blood vessels in an anastomotic attachment. Method and apparatus for enhanced delivery of treatment device to the intervertebral disc annulus. The suture ends and are detached from the snare cords 30 and 32typically by cutting.

A method as in claim 15wherein the complete knot comprises a square knot.