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Updated: Jun 22, 2026
Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
Extracorporeal "Giant" locking sliding knot in pediatric and neonatal minimally invasive surgery: indications,
1Division of Pediatric Surgery, University of the Witwatersrand, Johannesburg, South Africa. banieghbal@worldonline.co.za
Aim:
A prospective study to assess the clinical application of extracorporeal "Giant" locking sliding knot (GLSK) in pediatric and neonatal minimally invasive surgery (MIS).
Materials And Methods:
A total of 152 MIS, of various complexities were performed over a 14-month period with more than 1100 GLSKs used in 126 procedures.
Results:
There were no major complications or deaths in this cohort. Unraveling of the GLSK was observed in three instances (0.3%) secondary to excessive manipulation. Only a copolymer of glycolic acid/trimethylene carbonate material (Maxon suture; Covidien, Norwalk, CT) and polyproplene (Prolene suture; Ethicon, Sommerville, NJ) can be used for the GLSK technique due to their very smooth surface.
Conclusion:
Extracorporeal GLSKs can replace intracorporeal knots because they are safe, faster to tie, and reduce the surgeon's fatigue during complex MIS.
