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A Biomechanical Study of Laparoscopic 4S-Modified Roeder and Weston Knot Strength in 3–0 Polyglactin 910 and 3–0 Polydioxanone

Authors

  • Russell W. Fugazzi DVM,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
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  • Boel A. Fransson DVM, PhD, Diplomate ACVS,

    Corresponding author
    • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
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  • Katie M. Curran DVM,

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
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  • Howard M. Davis PhD,

    1. The Gene and Linda Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, WA
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  • John M. Gay DVM, PhD, Diplomate ACVS

    1. Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA
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  • Study performed at the Veterinary Applied Laparoscopic Training (VALT) laboratory, Washington State University.

  • Presented in part at the WSU College of Veterinary Medicine Student Research Symposium, October 20, 2009.

Corresponding Author

Boel Fransson, DVM, PhD & Dipl ACVS, Department of Veterinary Clinical Sciences, Washington State University, P.O. Box 646610, Pullman, WA 99164-6610

E-mail: bfransso@vetmed.wsu.edu

Abstract

Objective

To (1) evaluate biomechanical strength of 4 different laparoscopic knots using 2 suture types, and (2) evaluate carotid artery ligature bursting pressure of 2 knots using a single suture type.

Study Design

Biomechanical materials testing.

Sample Population

Suture material (3–0 polydioxanone, 3–0 polyglactin 910).

Methods

Four knot types were tested: 4S-modified Roeder (4SMR) Weston plus 3 square throws (W3S); Weston plus 3 granny throws (W3G); and a 4 square throw knot as a control (control); 24 specimens of each knot type were tied with 3–0 polyglactin 910 and 24 of 3 knot types (4SMR, W3S, control) were tied with 3–0 polydioxanone. Suture loop constructs were tested to 3 mm displacement failure and ultimate failure. Carotid artery ligation bursting pressure was tested using 10 samples each of 4SMR and W3S knots with 3–0 polyglactin 910.

Results

The W3S, W3G, and controls were similar. The 4SMR was similar to W3S using 3–0 PDS but the 4SMR had lower load to failure and greater elongation than the Weston using 3–0 polyglactin 910. The 4SMR had a higher slippage rate with 3–0 polyglactin 910. All ligatures withstood supraphysiologic pressures.

Conclusions

Surgeons using 3–0 polyglactin 910 should consider using the Weston knot with added throws during laparoscopic procedures.

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