Portal de Periódicos da CAPES

A Comparison of Knot Security of Commonly Used Hand‐Tied Laparoscopic Slipknots

2004; Wiley; Volume: 33; Issue: 5 Linguagem: Inglês

10.1111/j.1532-950x.2004.04072.x

1532-950X

Donna L. Shettko, David D. Frisbie, Dean A. Hendrickson,

Shoulder and Clavicle Injuries

Objective— To compare the peak force required for failure of hand‐tied laparoscopic slipknot ligatures. Study Design— In vitro mechanical evaluation of suture material/knot combinations. Sample Population— Four hand‐tied laparoscopic slipknots were studied. Three suture materials and 2 suture sizes were evaluated. Twenty samples of each group were tested, for a total of 400 samples. Methods— The 4S modified Roeder, modified Roeder, and Weston and Brooks laparoscopic slipknots using 0 polyglyconate, 0 polyglycolic acid, 1 polyglyconate, and 1 polydioxanone (PDS) were tested. A vertical distracting force (5 mm/s) was applied until failure. Mean peak force to failure was obtained for each suture material, size, and knot combination. Results— Mean (±SEM) peak force to failure of hand‐tied ligatures ranged from 156.8±9.1 N to 4.8±.4 N. The 4S‐modified Roeder had the highest mean peak force to failure. Ligatures tied with polyglyconate and size 1 suture had the highest mean peak force to failure. Conclusions— The 4S‐modified Roeder was significantly and consistently stronger than the other slipknots. Polyglyconate was superior to other suture materials. The 1 polyglyconate had the highest mean peak force to failure followed by 0 polyglyconate that exceeded the 1PDS. Clinical Relevance— The 4S‐modified Roeder slipknot using 1 polyglyconate has the greatest breaking strength of sutures tested and should be considered when performing laparoscopic ligatures.