A new knot-supporting instrument and knot technique for laparoscopic surgery.

Objective: We report here an instrument designed by Dr Hasan Bdrekci that provides support to the knot to facilitate knot tying in laparoscopic procedures. We call the device the 'B6rekci knot-supporting instrument' and the technique 'B6rekci's knot technique'

Methods: To evaluate the efficacy of this instrument, 17 surgeons performing laparoscopic surgery tied 3 knots using the classical intracorporeal method and then using the intracorporeal knot-supporting instrument. The times required to tie each knot were recorded and compared statistically.

Results: Comparing the 2 knotting methods, the time spent tying the knots was shorter with the knot-supporting instrument in all 3 trials and the difference was significant (P = 0.026) in the third trial.

Conclusions: This alternative technique can be used for all knots in laparoscopic surgery when classical intracorporeal knotting is difficult.