Initial throw locking internal knotting technique

Internal knotting is a highly versatile technique that closely resembles classic suturing. However, most intracorporeal knots are cumbersome and require a long time to master. We describe a simple, easy, and safe method for internal knotting that can also be used in open procedures and practiced until mastery is achieved. With this technique, the initial throw will never fail to hold tissues in apposition until the whole knot is constructed. The completed knot combines the maximum in suture support with a minimum of foreign body reactivity.