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Related Concept Videos

Modified Boxplots00:57

Modified Boxplots

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A standard box and whisker plot informs us about the spread of the data in a given sample. One can identify the minimum value, maximum value, first quartile value, second quartile or median value, and third quartile.
However, the box plot does not tell the reader about outliers - values that lie far from the center of the data. We can modify the standard box and whisker plot to identify the outliers and visualize the actual spread of the data in a sample.
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Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
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Modified-Release Drug Delivery Systems: Bioavailability01:30

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Modified-release (MR) dosage forms are designed to extend drug release over time, thereby maintaining stable plasma concentrations and reducing dosing frequency. However, their bioavailability is typically below 100% due to incomplete drug release and presystemic metabolism, and limitations in drug permeability across the gastrointestinal epithelium, all of which can restrict the fraction of the drug reaching systemic circulation. Consequently, studying the in vivo bioavailability of MR...
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Modified-Release Drug Delivery Systems: Overview01:19

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Modified-release dosage forms are designed to address the limitations of drugs with short biological half-lives. These forms maintain stable therapeutic drug concentrations over extended periods, reducing the need for frequent dosing. A consistent drug level helps minimize peak-trough fluctuations, which can reduce adverse effects, lower the risk of drug resistance, and improve overall treatment effectiveness.One common type of modified-release form is the extended-release (ER) formulation. ER...
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Modified-Release Drug Delivery Systems: Classification01:23

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Modified-release drug delivery systems improve drug efficacy and minimize side effects by controlling the rate and location of drug release. These systems fall into three categories: rate-programmed, stimuli-activated, and site-targeted.Rate-programmed systems release drugs at a predetermined rate, maintaining consistent therapeutic levels and reducing fluctuations that could lead to toxicity or subtherapeutic effects. These systems use polymeric matrices, reservoir-based designs, or osmotic...
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Modified-Release Drug Delivery Systems: Site-Targeted01:24

Modified-Release Drug Delivery Systems: Site-Targeted

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Site-targeted drug delivery systems enhance therapeutic efficacy while minimizing systemic toxicity and treatment costs. Unlike conventional methods, these systems ensure precise drug delivery, improving bioavailability and reducing side effects. Targeted drug delivery is classified into three levels. First-order targeting directs drugs to the capillary beds of specific organs or tissues. Second-order targets specific cell types, such as tumor cells, using receptor-mediated interactions.
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Related Experiment Video

Updated: Feb 13, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
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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

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Tying modified clinch knots during single-incision laparoscopic surgery.

Shuichi Fujioka1, Takeyuki Misawa1, Hiroaki Kitamura1

  • 1Department of Surgery, Jikei University Kashiwa Hospital, Kashiwa, Japan.

Asian Journal of Endoscopic Surgery
|February 28, 2018
PubMed
Summary

The modified clinch (MC) knot offers a solution for challenging knot-tying in single-incision laparoscopic surgery (SILS). This technique is particularly effective for Z-shaped sutures, improving efficiency and safety in minimally invasive procedures.

Keywords:
Clinch knotknot-tyingsingle-incision laparoscopic surgery (SILS)

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Techniques
  • Laparoscopic Surgery

Background:

  • Single-incision laparoscopic surgery (SILS) presents challenges for knot-tying due to limited workspace.
  • Extracorporeal knot-tying methods in SILS can be impractical and may cause tissue damage.

Purpose of the Study:

  • To introduce and evaluate a modified clinch (MC) knot for improved knot-tying in SILS.
  • To assess the efficacy of the MC knot, especially for Z-shaped sutures.

Main Methods:

  • A modified clinch knot with a locking mechanism was developed for SILS.
  • The MC knot was applied using a needle driver within the peritoneal cavity.
  • The technique involves pulling the needle through the knot and exiting the trocar, with locking achieved by manipulating the suture thread.

Main Results:

  • The MC knot was successfully used to tie 12 simple interrupted and 55 Z-shaped sutures in SILS.
  • The average time to tie an MC knot was 27 seconds.
  • The MC knot demonstrated a short sliding distance, suitable for Z-shaped sutures.

Conclusions:

  • The modified clinch knot is a feasible and effective knot-tying procedure for SILS.
  • The MC knot is particularly advantageous for securing Z-shaped sutures in single-incision laparoscopic surgery.