On the origin and evolution of the Roeder knot and loop--a geometrical review.
ABSTRACT The first laparoscopic sliding knot to be described was the Roeder knot; it has been used for a variety of procedures in all surgical disciplines. It was surmised that the introduction of new modifications in the geometry of the knot paralleled the introduction of its new indications, and that not all modifications improved its security. Therefore, a geometrical review was made of all modifications and all data on knot security and loop security of the knot were analyzed. The introduction of the original knot and its 14 applicable modifications paralleled the increase in minimally invasive techniques and the spread of these techniques in all the medical specialties. Roeder loop security depends predominantly on the number of initial turns around the standing part. Its knot security depends on the additional half hitches used to backup the knot after it has been tightened. Only a few of the modifications improved the security of the knot or its previous modifications.
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ABSTRACT: The Roeder knot is commonly used during laparoscopic suturing because it may be tied extracorporeally and slid down to the target tissue with a single pass of a knot pusher. However, it is significantly weaker than extracorporeally tied knots with several throws. We compared the usual Roeder knot to one that was modified by adding a fourth loop around the standing end of the suture and a second half-hitch to the completed knot. The modified knot (26.6 newtons +/- 15.3) was significantly stronger (p <0.05) than the standard Roeder knot (18.0 newtons +/- 12.1). If a single-pass extracorporeal knot is to be used, we recommend a modified Roeder knot when ligating pedicles at laparoscopy.The Journal of the American Association of Gynecologic Laparoscopists 02/1996; 3(2):305-7.
Article: New technique for sigmoid colectomy.[show abstract] [hide abstract]
ABSTRACT: A combination of laparoscopic and rectoscopic procedures has enabled complete resection of the sigmoid colon and eliminated the need for minilaparotomy when constructing the anastomosis or withdrawing the specimen. This combined procedure was performed in different ways in a series of animal models until the definitive technique had been standardized. These techniques were then successfully used in 15 consecutive medium-sized pigs. Histological evaluation of the specimens, including the anastomosis (examined 2-3 weeks after operation) confirmed the efficacy and safety of the method.British Journal of Surgery 01/1994; 80(12):1606-9. · 4.84 Impact Factor
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ABSTRACT: Premade chromic gut ligating Endoloops used in laparoscopic surgery are not always available. Handmade knots or loops, however, are equally effective, simpler, cheaper, and readily available. Techniques of making more than 10 handmade knots and loops are described and illustrated, and their uses are discussed. The thread can be introduced inside the abdominal cavity to loop around the proposed structure grasped by forceps, brought outside the abdomen, tied externally, and the knot pushed and tightened inside by pusher rod. Or, the knot may be fashioned outside the abdomen and introduced as a ready-made loop and tightened inside by a grasper.Surgical Laparoscopy Endoscopy & Percutaneous Techniques 01/1994; 3(6):477-81.