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Updated: Jun 3, 2026
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Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
Published on: September 12, 2025
A modified intracorporeal knot-tying technique using an endoknot cannula during laparoscopy: coiling and snaring
1Department of Obstetrics and Gynecology, Gangneung Asan Hospital, College of Medicine, University of Ulsan, Gangneung, Korea. buzzmi@chol.com
Summary
This study presents a modified intracorporeal knot-tying technique for minimally invasive surgery. The method simplifies knot tying in single-port or two-port laparoscopy, enhancing surgical efficiency.
Area of Science:
- Minimally Invasive Surgery
- Surgical Techniques
- Laparoscopy
Background:
- Surgical instruments in minimally invasive surgery, particularly single-port or 2-port techniques, have limited motion range.
- This limitation complicates intracorporeal knot tying compared to conventional laparoscopy.
Purpose of the Study:
- To introduce a modified intracorporeal knot-tying technique.
- To address the challenges of knot tying in restricted surgical environments.
Main Methods:
- Forming 2-3 loops with an endoknot cannula and preventing unlocking via grasper compression (coiling).
- Snaring formed loops onto a grasper and passing the suture's free end through the loops.
- Tying the suture over tissue using graspers, with the cannula functioning as a knot pusher.
Main Results:
- The modified technique is simple, safe, and fast to execute.
- Demonstrates an effective method for intracorporeal knot tying.
Conclusions:
- The modified technique is beneficial for all laparoscopic procedures requiring intracorporeal knot tying.
- It is particularly advantageous for single-port and 2-port laparoscopy, improving surgical outcomes.