| Assessing the adequacy of endoscopically tied knots: a functional approach. | |
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MedLine Citation:
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PMID: 15844018 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND STUDY AIMS: Endoscopic intracorporeal knots have potentially enormous applications in endoscopic surgery. We describe a method for testing the security of various types of endoscopically tied knots using a vessel perfusion manometer system. METHODS: A 4-cm segment of porcine splenic artery was placed on the mucosal surface of a pig stomach. The two ends of the vessel were brought out through the gastric wall and connected to a two-way manometer. One end was also joined to a pressure infusion bag. The stomach was mounted in an Erlangen training model. A long 3/0 nylon thread, previously introduced into the submucosal layer of the stomach and encircling the vessel, was brought out from the mouth. Three-throw square knots, Mayo knots, "surgeon's" knots and five-throw square knots were tied and pushed into place using a cap attached to a gastroscope. The pressure at the two ends of the artery was compared. If the pressure could be increased to over 200 mm Hg at one end without a change in the other, the knot was considered secure. RESULTS: Each type of knot was tested 12 times under endoscopic vision. The range for mean knotting time was 3.4 - 4.5 minutes. Five-throw knots took significantly longer to tie than three-throw knots (P < 0.005). There was one loose knot in each of the three-throw and Mayo groups, and three each in the "surgeon's" and five-throw groups (P > 0.05). CONCLUSIONS: This system is a reliable model for testing intracorporeal knots tied endoscopically. A three-half-hitches square knot with 3/0 nylon, tied using a flexible endoscope and knot-tightening cap, can withstand pressure up to 200 mm Hg. |
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Authors:
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B Hu; L C Sun; M Karmakar; P B Cotton; C J Gostout; R H Hawes; A N Kalloo; S V Kantsevoy; P J Pasricha; S C Chung |
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Publication Detail:
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Type: In Vitro; Journal Article |
Journal Detail:
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Title: Endoscopy Volume: 37 ISSN: 0013-726X ISO Abbreviation: Endoscopy Publication Date: 2005 May |
Date Detail:
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Created Date: 2005-04-21 Completed Date: 2005-08-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: Germany |
Other Details:
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Languages: eng Pagination: 415-7 Citation Subset: IM |
Affiliation:
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Endoscopy Center, Prince of Wales Hospital, The Chinese University of Hong Kong, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Endoscopy* Humans Manikins Manometry Perfusion Reproducibility of Results Shear Strength Splenic Artery / surgery* Stomach / surgery* Suture Techniques* Swine Tensile Strength |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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