Analysis of surgical movements during suturing in laparoscopy.

Abstract

Laparoscopic suturing is now recognized as a necessary component of minimally invasive surgery. Until recently it has been avoided due to the lack of proper instrumentation and systematic technique. The principles of magnified surgery are discussed as they apply to the laparoscopic field, with emphasis on visual perception, economy of motion, choreography of movements, and "flawless technique". The principles and techniques of needle loading, handling, and driving are presented, as are the series of movements involved in tying an intracorporeal square-slip knot.