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Ann R Coll Surg Engl. 2009 April; 91(3): 268.
PMCID: PMC2765024
Technical Notes and Tips
Bruce Campbell, Section Editor

DIY Surgical Knot-Tying Tool

The ability to tie a safe, secure knot is one the first and most fundamental skills that a surgeon learns. Traditional simulators that are used by trainee surgeons to practise knot tying are based around a fixed hook attached to a surface or attached inside of a cup to simulate knot tying down into the pelvis. It has been suggested that the more junior a trainee surgeon is the more force they apply to the structure being tied. In vivo, this can result in problems like vessel avulsion. This simple DIY technique allows a trainee surgeon to practise knot tying whilst also practising the skill of not applying too much force to the structure being suture ligated, something that can not be practised on a fixed hook simulator. An empty 330-ml drink can is needed. The ring pull is positioned upright as illustrated (Fig. 1). The can is placed on a piece of A4 paper and a circle drawn around the side of the can. The trainee then uses the ring pull to practise tying knots without moving the can outside of the circle or lifting the can from the surface. This provides for a cheap, simple and readily available training tool.

Figure 1
Illustration of the technique.

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England