The slip knot for dacryocystorhinostomy flap closure

During dacryocrystorhinostomy (DCR) surgery, anterior and/or posterior flaps are created and anastomosed with absorbable sutures. A prominent nasal bridge and recessed lacrimal crest can often make tying of the suture within a small incision difficult. We have simplified this tying process with the use of a slip knot. The knot is tied external to the incision and then slid into the operative site until the flaps are apposed.