Extracorporeal "Giant" locking sliding knot in pediatric and neonatal minimally invasive surgery: indications, techniques, and outcomes.

OBJECTIVE

A prospective study to assess the clinical application of extracorporeal "Giant" locking sliding knot (GLSK) in pediatric and neonatal minimally invasive surgery (MIS).

METHODS

A total of 152 MIS, of various complexities were performed over a 14-month period with more than 1100 GLSKs used in 126 procedures.

RESULTS

There were no major complications or deaths in this cohort. Unraveling of the GLSK was observed in three instances (0.3%) secondary to excessive manipulation. Only a copolymer of glycolic acid/trimethylene carbonate material (Maxon suture; Covidien, Norwalk, CT) and polyproplene (Prolene suture; Ethicon, Sommerville, NJ) can be used for the GLSK technique due to their very smooth surface.

CONCLUSIONS

Extracorporeal GLSKs can replace intracorporeal knots because they are safe, faster to tie, and reduce the surgeon's fatigue during complex MIS.