Online Articles: Technical ReportsOptimizing Laparoscopically Extracorporeal Knot Tying Using a Novel Pusher DeviceTu, Fung-Chao MD*; Sun, Hsu-Dong MD*; Ting, Wan-Hua MD*; Wu, Wen-Yih MD*; Lin, Ho-Hsiung MD, PhD*,†; Hsiao, Sheng-Mou MD*,†,‡ Author Information *Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei †Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei ‡Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan The authors declare no conflicts of interest. Reprints: Sheng-Mou Hsiao, MD, Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya South Road, Banqiao District, New Taipei City, 220, Taiwan (e-mail: [email protected]). Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2017 - Volume 27 - Issue 3 - p e31-e35 doi: 10.1097/SLE.0000000000000398 Buy SDC Metrics Abstract The aim of this study was to evaluate the efficacy and feasibility of a novel pusher device for performing extracorporeal knot tying. Each of the 3 laparoscopists randomly performed 10 device-assisted double sheet bends (the device group), ten 4s modified Roeder sliding knots (the sliding group), and 10 laparoscopic traditional extracorporeal static surgeon’s knots (the static group). All knots and 5 unknotted threads were measured for strength. The device group had higher knot strength, lower knotting failure rate, and shorter knotting time compared with the sliding group. The knot strengths of the successful knots in the device group were consistent with those obtained in the static group, and higher than the sliding group. Our laparoscopic novel pusher device should be an effective device in assisting knot tying with the advantages of steady and strong knot strength, lower failure rate, and shorter knotting time. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.