New multipurpose endoknot device for laparoscopic surgery

Abstract

Extracorporeal knot tying for the ligation and suture ligation of various structures is becoming more important with the increasing popularity of laparoscopic surgery, especially in complicated cholecystectomies with the need to do intraoperative cholangiography, and in other advanced procedures. We have designed a new multipurpose endoknot device that can be used to: (1) push the knot of a pre-tied loop, (2) facilitate the extracorporeal tying of square knots, and (3) facilitate the suturing of tissues, using either a slip knot or a square knot. The device consists of a simple stainless steel rod with a 3-mm lateral hole at its working end which connects to a 1-mm hole at the tip. The blunt tip lessens the chance of inadvertent injury to the liver and other organs during knot tying. We have used this instrument in laparoscopic cholecystectomy with intraoperative cholangiography, and in laparoscopic hernia repair, colon resection, and thoracoscopic esophagectomy, with great success and with no morbidity attributable to its use. © 1994 Springer-Verlag.