Summary
Laparoscopic suturing is key element of advanced surgery. We have developed and teach a hierarchical system which breaks knot tying down into to a number of easily completed steps. These steps build on skills that have been learnt in previous modules. The understanding and repeated practice helps to acquire required skill to master this art. Intracorporeal knot tying is then combined with needle driving in models which attempt to build transferable skills. For example for Laparoscopic hysterectomy we have a vault closure model. Extracorporeal knots have also their place in securing the pedicles, vascular ligatures and closing the myometrium after myomectomy. In this module we also show case the extracorporeal knot and its clinical application.