| abstract |
A suture applier instrument for tying suture and loop ligatures in laparoscopic excisional procedures such as LAVH, tubal ligation, salpingectomy, cophorectomy and appendectomy; in the repair of the fallopian tubes, uterus and ovaries; and in retropubic colposuspension using locking slip knots; and an efficient extracorporeal method to effectively lock them. The slip knot is held at the tip of the suture applier instrument and is kept in position on the target tissues while its two suture strands are operated extracorporeally, tying the loop ligature with one of the strands and locking or tightening the knot itself with the other. Additional hitch knots may be introduced and tied after the slip knot has been applied, using the same instrument. New knots, spool for pretied knot sutures and knot tying techniques for use with the suture applier are presented. |