Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SUTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 865 records · Page 48Linked to original sources
PubMed2000

Comparative analysis of cranial suture complexity in the genus Caiman (Crocodylia, Alligatoridae).

The variation in degrees of interdigitation (complexity) in cranial sutures among species of Caiman in different skull regions was studied by fractal analysis. Our findings show that there is a small species effect in the fractal dimension of cranial sutures, but most variation is accounted for by regional differentiation within the skull. There is also a significant interaction between species and cranial regions. The braincase sutures show higher fractal dimension than the facial skull sutures for all three species. The fractal dimension of nasal-maxilla suture is larger in Caiman latirostris than in the other species. The braincase sutures show higher fractal dimensions in C. sclerops than in the other species. The results suggest that different regions of the skull in caimans are under differential functional stress and the braincase sutures must counteract stronger disarticulation forces than the facial sutures. The larger fractal dimension shown by C. latirostris in facial sutures has probably a functional basis also. Caiman latirostris is known to have preferences for harder food items than the other species.

Alligators and Crocodiles↗
PubMed2005

[Clinical and histopathological study of tissue reactivity to monofilament suture materials: nylon and poliglecaprone 25 in rats].

PURPOSE: The aim of this experimental study was to evaluate through a clinical and histopathological analysis the tissue reactivity caused by two monofilament sutures nylon and poliglecaprone 25 on the internal and external sutures in rats. METHODS: For this study, we used forty male Rattus novergicus (Wistar rats). The experimental procedures were incisions and divulsions performed on the back of the animals' thighs. Internal and external sutures were done on the right thigh using nylon 0-5, and on the left thigh using poliglecaprone 25 0-5. The animals were distributed in 4 groups of 10 rats, according postoperatory period on the 7, 14, 21 and 28 days, G1 (7th day), G2 (14th day), G3 (21th day) and G4 (28th day). The clinical assessment aimed to verify the existence of dehiscence, exsudate and edema. The histopathologic analysis was intended to evaluate the inflammatory reaction, foreign body giant cells, fibroblastic proliferation and fibrosis. RESULTS: Clinically, no changes were found on groups studied. Histopathological analysis inflammatory reaction, foreign body giant cells, fibroblastic proliferation and fibrosis were higher on the internal sutures with nylon. On the sutures done with poliglecaprone 25 showed an increase in tissue reactivity passing postoperatory period. CONCLUSIONS: On the basis of the methodology used in the study, it was concluded that external sutures done with nylon produce less tissue reactivity; on internal sutures, however, this material contributes to the maintenance of the tissue reaction. The external sutures done with poliglecaprone 25 showed a greater tissue reaction; on the external sutures the tissue reaction decreased while the thread was being absorbed.

Animals↗
PubMed1995

Growth of the cranial vault in rabbits with congenital coronal suture synostosis.

Craniofacial growth data from craniosynostotic children have shown that suture immobilization results in predictable restrictions of cranial vault growth in a direction perpendicular to the affected suture and compensatory growth at sutures perpendicular to the affected one. This study tests these predictions by using rabbits with nonsyndromic congenital coronal suture synostosis. Data were collected from 96 rabbits divided into three groups: 42 unaffected litter mate controls, 33 partially synostosed rabbits, and 21 completely synostosed rabbits. Markers were placed bilaterally on either side of the vault sutures at 1.5 weeks of age. Serial radiographs were taken at 1.5, 6, 12, and 18 weeks of age for assessment of growth at the vault sutures and of various cranial landmarks. Results revealed that completely synostosed animals had significantly (p < .05) shorter cranial vaults, reduced growth at the coronal suture, and increased growth at the sagittal, frontal, and squamosal sutures compared with unaffected rabbits. Results also showed that the calvarial growth observed in this craniosynostotic rabbit model closely reflects predicted compensatory patterns seen in human clinical populations and that this rabbit model is valuable for understanding the pathogeneses and craniofacial growth patterns of humans with premature cranial suture synostosis.

Adaptation, Physiological↗
PubMed2002

Fibroblast growth factor 2 induces increased calvarial osteoblast proliferation and cranial suture fusion.

OBJECTIVE: Craniosynostosis has been associated with fibroblast growth factors (FGFs) and their receptors. The purpose of this study was to quantitatively determine the effect of FGF2 on rat calvarial osteoblasts and a rat cranial suture formation model. DESIGN: Fetal rat calvarial osteoblasts were cultured with and without FGF2. Cell attachment and proliferation was determined by alamar Blue dye assay and cell morphology by toluidine-blue staining. In rat calvarial organ culture, postnatal day 15 rat calvariae with dura mater were placed in serum-free media with and without FGF2. A unique quantitative analysis of suture fusion was developed by obtaining measurements of suture bridging in histological serial sections at progressive stages of fusion. RESULTS: Attachment for cells treated with FGF2 was similar to control. In contrast, proliferation was higher for cells treated with FGF2 while maintaining an osteoblastic morphology. After 5 days in organ culture, FGF2-treated posterior frontal sutures showed a dramatic increase in fusion, compared with untreated controls. This increased fusion was maintained throughout days 7 and 10 in culture. Also, fusion was enhanced on the dural side of the suture, as is normally observed in vivo, and the normal tissue architecture was maintained. CONCLUSIONS: These results indicate that FGF2 can promote rat osteoblast attachment and normal cell morphology as well as induce cell proliferation. In calvarial organ culture, FGF2 treatment produced an enhanced suture fusion. These results provide further support for a critical role for FGF2 in cranial suture development. These studies also present a new quantitative approach to evaluating the effect of suture-perturbing growth factors on cranial suture fusion.

Analysis of Variance↗
PubMed2003

Delivery of transforming growth factor-beta2-perturbing antibody in a collagen vehicle inhibits cranial suture fusion in calvarial organ culture.

OBJECTIVE: To determine whether antibody perturbation of Tgf-beta, delivered in a collagen gel, could inhibit cranial suture fusion. DESIGN: Attachment and proliferation of osteoblasts cultured on a collagen gel with or without anti-Tgf-beta2 antibody were determined by AlamarBlue dye assay and cell morphology by toluidine-blue staining. In rat calvarial organ culture, collagen gel with and without anti-Tgf-beta2 antibody was injected subperiosteally over the posterior frontal suture of postnatal day 15 rat calvariae. A quantitative analysis of suture fusion was used to measure suture bridging in histological serial sections at various time points. RESULTS: Attachment and proliferation for cells cultured on collagen gel with anti-Tgf-beta2 antibody were similar to collagen gel controls. Although proliferation was lower than on tissue culture plastic, cells treated with anti-Tgf-beta2 antibody maintained an osteoblastic morphology. After 7, 10, and 15 days in organ culture, anti-Tgf-beta2 antibody treatment caused a reduction in the percent bridging of posterior frontal sutures, compared with controls. Sutures exposed to anti-Tgf-beta2 antibody and fibroblast growth factor-2 concurrently did not show an inhibition of bony bridging. CONCLUSIONS: These results support previous reports suggesting a role for Tgf-beta2 in cranial suture fusion. In cell culture the collagen gel, both with and without anti-Tgf-beta2 antibody, promoted similar osteoblast attachment, proliferation, and osteoblastic morphology. In organ culture anti-Tgf-beta2 antibody was delivered in a bioactive state via a collagen gel to inhibit cranial suture fusion. Also, the results suggest that the inductive effect of fibroblast growth factor-2 is not dependent on Tgf-beta2 activity. Together, these results provide further support for the role of Tgf-beta2 in cranial suture fusion.

Analysis of Variance↗
PubMed1996

Evaluation of hindpaw position in rats during chronic constriction injury (CCI) produced with different suture materials.

Bennett and Xie (1988) described an experimental peripheral neuropathy that is produced by loosely ligating a rat's left sciatic nerve with chromic gut suture. Four ligations, which are tied tightly enough to constrict the nerve and retard epineurial blood flow, produce a chronic constriction injury (CCI). Maves et al. (1993) reported that if the ligations are tied more loosely (i.e., no retardation of blood flow) than those that produce the CCI, rats exhibit postural changes only when the ligations are of chromic gut. We decided to evaluate effects of different suture materials on the abnormalities in paw position associated with the CCI (Attal et al., 1990). Five groups of rats were included in this study. In three of the groups, the CCI was produced with chromic gut, plain gut, or polyglactin (Vicryl) suture. Rats in the fourth group served as sham injury control animals, and rats in the fifth group served as unoperated control animals. Our results indicate that the position in which the rats held the affected hindpaw varied significantly among treatment groups. Rats whose CCI was induced with chromic gut suture spent more time with the hindpaw in an abnormal position than rats in the other treatment groups. And as compared to rats in the unoperated control group, rats whose CCI was induced with either plain gut or polyglactin suture also spent more time with the hindpaw in an abnormal position. Though these different suture materials produced similar degrees of nerve constriction, the effects on paw position were greater with chromic gut suture. These results suggest that chromic gut suture, when used to produce the CCI, may have more than just a constrictive effect on the sciatic nerve. However, since all suture materials produced changes in paw position, constriction is likely to play an important role in the development of abnormalities in paw position observed in rats with the CCI.

Animals↗
PubMed1984

Roentgen stereophotogrammetric analysis of restricted periods of neurocranial suture immobilization in rabbits.

The effect of temporary fusion of sutures on craniofacial growth was studied biometrically in 4-week-old male New Zealand White rabbits. Tantalum bone markers were implanted in the cranial vault, and the coronal suture immobilized with isobutyl-2-cyanoacrylate adhesive. Linear craniectomy was performed after 2 or 6 weeks of sutural growth restriction (four animals in each group). The animals were followed for approximately 17 weeks. Early craniectomy resulted in greatly increased coronal suture bone separation (175% of control growth rates in peers and 125% of maximal control rates). Growth after late craniectomy showed an age-dependent lower rate, but still the overshoot markedly surpassed controls (210% of control rates in peers and 65% of maximal control growth rates). Overall, both exhibited overcompensation in coronal suture growth. A rapid compensation of adjacent sutures to temporary growth restriction and a tendency toward spontaneous correction following release of growth inhibition were demonstrated. Thus, the total anteroposterior growth of the combined frontonasal and coronal sutures nearly equaled that of control animals. Following linear craniectomy, volumetric calvarial expansion increased considerably in both early and late groups, due to compensatory coronal suture growth, but probably due also to spatial bone rearrangements. Based upon the findings, the length of the suture immobilization period seems critical to longitudinal and volumetric growth as well as to subsequent compensatory activity after surgical correction.

Animals↗
PubMedDate not supplied

Effect of bipolar cautery on tensile strength of 6-0 polyglactin 910 suture.

PURPOSE: To determine the effect of bipolar cautery on 6-0 polyglactin 910 suture. METHODS: Three groups of sutures were tested for maximum tensile strength. The first group (direct cautery) had bipolar cautery applied directly to the suture. The second group (scleral cautery) had bipolar cautery applied directly on top of the sclera, through which the suture was passed one-half scleral thickness. The third group (control) had no application of cautery to the suture. RESULTS: The mean tensile strength for the direct cautery sutures (n=8) was 553 g; for the scleral cautery sutures (n=7), 577 g; and for the control sutures (n=5), 553 g. There was no statistically significant difference in tensile strength between the three groups, with the analysis of variance yielding P=.56. CONCLUSION: Bipolar cautery causes little to no risk of reducing the tensile strength of 6-0 polyglactin 910 suture in the setting of strabismus surgery.

Cautery↗
PubMed2004

Atraumatic intracutaneous skin closure with self-made fishing line suture compared to commercial thread.

OBJECTIVE: The aim of this study was to prove, whether the intracutaneous skin closure with self made fishing line suture is equivalent to commercial sutures. DESIGN: It was a randomised blinded animal study. SETTING: The study was performed in December 2002 at the Muhimbili University College of Health Sciences in Dar-es-salaam. SUBJECTS: Both German surgeons from Mannheim, and Tanzanian surgeons from Dar es salaam operated on nine one year old Tanzanian domestic sheep. INTERVENTIONS: 108 standardised cutaneous wounds on the backs of the animals were closed by intracutaneous sutures either with self produced fishing line suture or a commercial nylon suture (Ethilon). MAIN OUTCOME MEASURES: The clinical and histological outcomes, as well as the costs of this self-made fishing line suture, with a commercial nylon thread were evaluated and compared. RESULTS: There are no significant differences between the two sutures in histological or clinical findings, or in the reported ease of use by the surgeons. The cost of a self-produced atraumatic thread is US$ 0.12, less than one-twentieth of the cost of the commercial thread. CONCLUSION: Self-made fishing nylon suture has characteristics and properties in sheep skin wounds comparable to commercial nylon suture. The advantage of the commercial thread is the guaranteed quality assurance. It is discussed whether this quality assurance justifies the large price difference, and whether the self-produced thread should be recommended to surgeons in countries where the costs of surgical material often remains an obstacle for life saving operations.

Animals↗
PubMed2002

Suturing technique for control of postkeratoplasty astigmatism and myopia.

PURPOSE: We previously demonstrated that selective suture removal reduces keratoplasty astigmatism; however, a myopic shift was induced with increasing number of interrupted sutures removed. This study is an attempt to determine the effects of a modified surgical technique on postkeratoplasty myopia, astigmatism, and anisometropia. METHODS: Optical penetrating keratoplasties were performed on 92 eyes of 84 patients. The study group consisted of 92 consecutive penetrating keratoplasties performed using 12 interrupted 10-0 nylon sutures and a tight 12-bite continuous suture, and use of an average keratometry (K) reading of 46.00 diopters for eyes undergoing combined and intraocular lens (IOL) exchange procedures. All patients had refraction, keratometry, and videokeratoscopy postoperatively, starting at 6 weeks and at the completion of selective suture removal. RESULTS: Prior to suture removal, the average spherical equivalent was -0.160 +/- 3.59 diopters. It was -1.58 +/- 3.66 diopters at the completion of suture removal at 1 year and -1.44 +/- 3.72 at the last follow-up visit, averaging 20.7 months. Final residual refractive, keratometric, and videokeratoscopic astigmatism was 2.81 +/- 1.82, 4.19 +/- 2.94, and 3.58 +/- 2.03 diopters, respectively. Anisometropia, using the spherical equivalent of the operated and fellow eyes, was 2.49 +/- 2.25 diopters at completion of the study. A best corrected visual acuity of 20/50 or better was achieved in 50 patients (59%). CONCLUSIONS: Low myopic spherical equivalent refraction and anisometropia with moderate residual astigmatism were achieved by using tighter continuous sutures, an average K reading of 46 diopters for calculation of IOL power, and selective removal of fewer sutures.

Adult↗
PubMed2002

An innovative surgical suture and needle evaluation and selection program.

This report describes an innovative suture and needle clinical evaluation program jointly designed by hospital representatives of Consorta, Inc., a healthcare resource management and group purchasing organization, and United States Surgical/Davis & Geck Sutures (USS/D&G), manufacturer of surgical biomaterials. Nineteen Consorta shareholder hospitals enrolled 699 surgeons to participate in Phase I of this nonexperimental observational study of the clinical performance of surgical needles and sutures. Performance characteristics of the sutures and needles produced by USS/D&G, which were evaluated in 3407 surgical procedures, included packaging and ease of opening, needle strength and sharpness, tissue drag, knot security, tensile strength, and clinically acceptable and unacceptable determinations. In these 30-day studies, the surgeons concluded that the needles and sutures were clinically acceptable in 98.1% of the evaluations. The general, cardiothoracic, and orthopedic surgeons, who performed 73.8% of the product evaluations, reported that the suture and needle products were clinically acceptable in 97.2% of the evaluations. More than half (50.1%) of the evaluations involved the POLYSORB* braided synthetic sutures,which received a clinically acceptable rating in 98.4% of the evaluation. The next most frequently used sutures were the SOFSILK*, followed by the monofilament nylon suture. SOFSILK* was found to be clinically acceptable in 98.7% of the evaluations, whereas the monofilament nylon was noted to be clinically acceptable in 96.3% of the evaluations. Surgical needles made by USS/D&G had a 97.9% clinical acceptability rating.

Attitude of Health Personnel↗
PubMed2003

[Sutures in skin surgery].

Dermatologists performing skin surgery mostly use the square knot. Other underused or even forgotten suturing techniques may still be helpful in some instances. We shall emphasize some simple techniques such as the horizontal mattress suture, the "cross stitch", the "corner stitch" (half buried mattress suture), the buried dermal suture, the buried vertical mattress suture, the continuous mattress suture and the running intradermal suture. In given circumstances, all of them may improve suturing and promote healing. Technical aspects, advantages and disadvantages of each type of suture will be briefly described.

Dermatologic Surgical Procedures↗
PubMed1992

Effect of suture technique on early healing of intestinal anastomoses in rats.

OBJECTIVE: To see if the site and tension of sutures had any influence on early breaking strength in intestinal anastomoses. MATERIAL: 161 Male Wistar rats. INTERVENTIONS: First experiment: after laparotomy and division of the ileum an inverted end to end anastomosis was made in a single layer with 14 interrupted sutures of 7/0 polypropylene. All sutures were inserted 3 mm from the cut edges. The rats were randomly allocated to one of four groups according to the size of the loop of suture used: tight (n = 38), 0.4 mm (n = 22), 0.9 mm (n = 35), or 2.0 mm (n = 24). Second experiment: the method used was the same except that sutures were placed 1.5 mm from the cut edges and the rats were randomly allocated to one of two groups according to the size of loop of suture--tight (n = 20), or 0.9 mm (n = 22). MAIN OUTCOME MEASURES: Breaking strength measured in a tensiometer (both experiments); and myeloperoxidase activity/g tissue, hydroxyproline content and solubility/biopsy specimen (first experiment only). RESULTS: Breaking strength decreased proportionally the tighter the sutures were tied, and the differences were significantly greater when the sutures were placed closer to the cut edges. Anastomotic myeloperoxidase activity, hydroxyproline content, and soluble: total hydroxyproline ratio were similar in all groups. CONCLUSION: Tight sutures may promote proteolytic tissue degradation by reducing the local availability of circulating proteinase inhibitors.

Anastomosis, Surgical↗
PubMed1992

Global left ventricular performance and regional systolic function after suture annuloplasty for chronic mitral regurgitation.

BACKGROUND: In surgery for chronic mitral regurgitation, the mitral subvalvular apparatus, including annulus, may play an important role in preserving left ventricular (LV) performance. The suture annuloplasty for mitral regurgitation allows annular contraction of the mitral valve. The potential effects of suture annuloplasty on the postoperative LV performance have not been fully defined. METHODS AND RESULTS: Global and regional LV function in 12 patients with suture annuloplasty were compared with 12 patients with conventional mitral valve replacement (MVR). Cineangiography and echocardiography were obtained before and 10.8 months after surgery. End-diastolic volume index and end-systolic volume index decreased significantly in both groups after surgery (p < 0.01). Ejection fraction remained unchanged in the suture annuloplasty group, whereas it decreased significantly in the MVR group after surgery (p < 0.01). There was a significant inverse relation between ejection fraction and end-systolic wall stress in the two groups after surgery (suture annuloplasty group, r = -0.69, p = 0.01; MVR group, r = -0.60, p = 0.04). The intercept on the y axis was significantly (p < 0.005) higher in the suture annuloplasty group than in the MVR group. In the suture annuloplasty group, cross-sectional area ejection fraction at the mitral valve level and at the papillary muscle level by LV two-dimensional echocardiography remained unchanged after surgery. In the MVR group, they decreased significantly after surgery (p < 0.01). There was a significant correlation between the cross-sectional area ejection fraction and the global ejection fraction at both levels after surgery. Therefore, the improvement of the regional wall motion can be attributed to the improvement of the global LV performance after suture annuloplasty. CONCLUSIONS: These data suggest that suture annuloplasty can provide more desirable postoperative LV systolic performance than conventional MVR by preserving both the contraction of the mitral annulus and the mitral valvular-ventricular interaction.

Echocardiography↗
PubMed1992

Physical and biologic impermeability of intestinal sutures in the first twenty-four hours after operations on the gastrointestinal tract.

The author has substantiated a concept that in the general notion of the impermeability of intestinal sutures, it is necessary to distinguish between physical impermeability (imperviousness of sutures to liquids and gases) and biologic impermeability (imperviousness of sutures to microbes and toxins). It was established in experiments on 165 dogs that infection that invaded peritoneum during operation disappeared from the peritoneal cavity within an hour of small-bowel and stomach surgery and within 1 1/2 hours of colon surgery. Then a period of sterility of peritoneum was observed, which lasted for 8 to 9 hours after operations on the stomach and the small bowel (p = 0.01) and for 4 to 7 hours after operations on the colon (p = 0.01). In the following hours the peritoneal cavity was infected through physically hermetic intestinal sutures. At the end of 24 hours the peritoneum of operated organs showed the presence of 10(4) to 10(6) intestinal microbes. Greater omentum, bowel loops, and their mesentery adhered to the suture in response to the infection through the suture. Complete covering of the suture with adjacent viscera prevented infection of the peritoneal cavity through the suture. The author suggests a well-grounded concept of the leading role of infection through a physically hermetic intestinal suture in the development of postoperative peritonitis and peritoneal adhesions.

Anastomosis, Surgical↗
PubMed2003

Biomechanical study on the suture strength of ligament in cruciate ligament reconstruction.

OBJECTIVE: To test the suture strength on the tendon or ligament end and evaluate the stitch in the reconstruction of cruciate ligament and its clinical application. METHODS: Twenty-four specimens of patellar tendon with free ends were divided into 3 groups: Group I (3 Krackow stitches), Group II (2 Krackow stitches) and Group III (2 Krackow stitches with the first stitch passing through the tendon tissue as a modified Krackow stitch). These 3 groups were further divided into 6 subgroups according to different suture materials, No 1 Ethilon or stainless steel wire (phi=0.4 mm). Tensile test was undertaken to find out the least stitches with efficient suture pattern. RESULTS: Two Krackow locking stitches had stronger strength than 0.4 mm-diameter stainless steel wire. The fixation strength of 2 stitches with No 1 Ethilon was more than 80 N, superior to the failure strength of the material itself. The same strength was maintained if the first stitch was across the tendon tissue transversely. There was no statistically significant difference in the suture strength between 2 and 3 Krackow locking stitches. CONCLUSIONS: The suture strength is greater than the failure strength of the suture material. Less suture exposure can be achieved when the first stitch is across the tendon tissue while maintaining a comparable strength to other sutures. To attain higher suture strength, stronger materials or multiple strands rather than more stitches are preferred. Therefore, a rapid early rehabilitation of range of motion (ROM) is possible and reliable in practice.

Anterior Cruciate Ligament↗
PubMed2004

A comparison of suture retention strengths for three biomaterials.

BACKGROUND: The suture holding capacity, suture retention strength, and burst strength of three biomaterials (Marlex), SIS, and PeriGuard) were evaluated to compare their performance characteristics in an ex vivo setting representing the immediate postoperative period. MATERIAL/METHODS: A circular defect was created in the fascial tissue of the abdominal aponeurosis collected from normal dogs. Defects were repaired with either Marlex (polypropylene mesh), Periguard (bovine pericardium) or small intestinal submucosa (SIS) using 2-0 prolene and a 1.0-cm suture bite. The force required to induce failure at the repair site was recorded as the suture-holding capacity. Suture retention strength was calculated as the load distribution over the specimen cross-section in contact with the suture at the time of rupture. Burst strength of the raw materials was also measured. RESULTS: The suture-holding capacity was 370.9+/-56.2 N for Marlex; 214.3+/-36.1 N for Periguard, and 287.9+/-34.3 N for SIS. The suture retention strengths were: Marlex, 413.4+/-59.7 N/mm2; Periguard, 97.0+/-20.1 N/mm2; and SIS, 106.9+/-12.7 N/mm2. The burst strength of Marlex, Periguard and SIS were 476.7+/-50.8 N, 432.12+/-82.1 N, and 433.6+/-79.5 N respectively. CONCLUSIONS: All three materials provide adequate strength and suture-holding capacities to be of use in the repair of soft tissue defects.

Animals↗
PubMedDate not supplied

Evaluation of specialized laparoscopic suturing and tying devices.

BACKGROUND: Laparoscopic suturing and tying constitute advanced minimally invasive surgery skills. Developing proficiency in the standard methods with needle drivers is often an arduous process. Recent advances in laparoscopic instrumentations has allowed for easier methods of suturing and tying. This study investigated the hypothesis that the use of a specialized suturing device and a specialized tying device allows inexperienced medical students to suture and tie laparoscopically. METHODS: Preclinical medical students who had not received any training in open or laparoscopic surgery were included in this investigation. Each student was given a 5-minute demonstration of a specialized suturing device and a specialized tying device. The medical students were not allowed to deploy either device before actual use. After the demonstration, each student was given the device to use in a porcine model. Times were recorded and a subjective grade was given for each student. RESULTS: Twenty medical students were involved in this study. All medical students were able to complete the task of suturing and tying. The average time to suture was 104.6 seconds and the average time to tying was 31.2 seconds. The average subjective performance grade was 90 (out of 100). CONCLUSION: Specialized devices are easy to learn and use for laparoscopic suturing and tying with minimal instruction even for inexperienced medical students. Even surgeons who are not well versed in laparoscopic surgery should be able to suture and tie with certain laparoscopic instruments.

Animals↗