A knot-pusher technique with hand-tying precision through a mini-thoracotomy

Area of Science:

• Cardiovascular Surgery
• Minimally Invasive Surgical Techniques
• Surgical Instrumentation

Background:

• Minimally invasive cardiac surgery (MICS) requires specialized instruments for effective knot tying.
• Traditional one-handed knot tying offers precision but can be challenging in MICS.
• Existing knot-pushing devices aim to facilitate knot securement in endoscopic procedures.

Purpose of the Study:

• To document the application of a knot-pusher technique in MICS.
• To evaluate the feasibility of using a long-shaft knot-pushing device with a one-handed knot-tying rationale.
• To assess the precision and security of knots tied using this method.

Main Methods:

• Application of a knot-pusher technique through a mini-thoracotomy.
• Utilizing an existing long-shaft knot-pushing device.
• Implementing the principles of traditional one-handed knot tying.

Main Results:

• The knot-pusher technique was successfully applied in MICS.
• The method achieved knot-tying precision comparable to traditional hand-tying.
• Tight and secure knots were consistently achieved.

Conclusions:

• The knot-pusher technique is a viable option for knot tying in MICS.
• This approach combines the benefits of existing instrumentation with established knot-tying principles.
• It offers a practical solution for achieving secure knots in minimally invasive cardiac procedures.