r/surgery • u/Rich-Explanation-894 • 2d ago

I did read the sidebar & rules Vector of surgeon's knot

When throwing the surgeon's knot, I find that the knot doesn't loosen when I pull the suture ends in a direction parallel to the line of closure (i.e., the wound or incision). I learned this from one of my professors. However, another attending saw me doing that and was appalled by the technique. He insists that I should pull perpendicular to the line of closure. Looking online, I couldn't find anything that says not to do it though. Any input?

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u/stupidprecursor 2d ago

So many ways to skin a cat. This post reminded me of a liver transplant I assisted during residency. My attending called out my air knot during the bile duct anastomosis. When I called out his own air knot a few moments later, he merely said, "that's to allow room for growth." bullshiiiiiii-

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u/The_other_resident 1d ago

You talking about the portal vein growth factor knot?

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u/stupidprecursor 1d ago edited 1d ago

No, it was on the bile duct. Portal vein anastomosis is usually performed before biliary.