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Home / Equine Research Bank / BMC Vet Res / Parallel alternating sliding knots are effective for ligatio...
BMC veterinary research2014; 10 Suppl 1(Suppl 1); S10; doi: 10.1186/1746-6148-10-S1-S10

Parallel alternating sliding knots are effective for ligation of mesenteric arteries during resection and anastomosis of the equine jejunum.

Abstract: In literature only one article describes and compares methods of achieving hemostasis in equine mesenteric arteries during jejunal resection and anastomosis, and most textbooks favor ligating-dividing mechanical devices. The latter method cannot always be used, not least because the devices are expensive and in some cases even contra-indicated. Various types of knots, including sliding knots, are widely used to provide hemostasis in laparoscopy. Methods: Portions of jejunum with associated mesenteric vessels were collected from 12 horses at a local abattoir. These were divided into 24 specimens containing five mesenteric arteries each. Each artery was closed with a triple ligature. In group A, a surgeon's knot was used to tie the ligatures (two circumferential and one modified transfixing) while in group B all ligatures (three circumferential) were tied with a parallel alternating sliding knot. Both groups were divided ino two subgroups depending on suture material used (multifilament or monofilament suture material). Time to perform ligatures for every specimen were recorded and compared between groups. Results: Ligation of mesenteric arteries was significantly faster to perform with sliding knots than with surgeon's knots, both with monofilament and multifilament suture material. With multifilament suture material, the leaking pressure of sliding knot ligatures was significantly higher than that of surgeon's knot ligatures. With monofilament suture, there were no statistically significant differences in leaking pressure between ligature methods. Both ligating methods were stronger with monofilament suture material than with multifilament suture material. Conclusions: Regardless of the ligature used, monofilament suture material performed better than multifilament suture material to achieve hemostatic knots. Independently of the suture material, the sliding knot is comparable or better than the surgeon's knot in providing hemostasis, and is faster to perform.
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Publication Date: 2014-07-07 PubMed ID: 25238115PubMed Central: PMC4122897DOI: 10.1186/1746-6148-10-S1-S10Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates the efficacy of using parallel alternating sliding knots for ligating mesenteric arteries during resection and anastomosis of the equine jejunum. It concludes that such knots can provide effective hemostasis and are also quicker to perform when compared to surgeon’s knots.

Introduction

  • This study expands on existing literature that discusses techniques for achieving hemostasis in equine mesenteric arteries during operations on the equine jejunum – part of the small intestine in horses. Mechanical devices for ligating and dividing are commonly favored, but these can be expensive and may be contra-indicated in some cases.
  • With this in mind, the research explores the use of different types of knots, focusing on sliding knots, which are commonly used in laparoscopy to control bleeding.

Methodology

  • The research used jejunal samples with associated mesenteric vessels from 12 horses. Each specimen was divided into groups with each group using a different ligature technique and material.
  • In group A, a surgeon’s knot was used to tie the ligatures, whereas in group B, parallel alternating sliding knots were used. The groups were further divided depending on the suture material used, either multifilament or monofilament.
  • The time it took to perform the ligatures for each specimen was recorded and compared between groups.

Results

  • Results demonstrated that ligating mesenteric arteries was significantly faster when using sliding knots as opposed to surgeon’s knots, regardless of the type of material used.
  • When multifilament suture material was used, the sliding knot ligatures also exhibited a significantly higher leaking pressure than surgeon’s knot ligatures.
  • With monofilament suture material, there weren’t any significant differences in leaking pressure between the two knot types.
  • Regardless of the type of knots, both ligating methods showed greater strength when using monofilament suture material as opposed to multifilament suture material.

Conclusions

  • Ultimately, regardless of the type of ligature technique used, monofilament suture material performed better than multifilament suture material in aiding hemostasis.
  • The sliding knot was found to be comparable to, if not better than, the surgeon’s knot in providing hemostasis. Furthermore, the sliding knot was also faster to perform, giving it an advantage in surgical settings.

Cite This Article

APA
Gandini M, Giusto G, Comino F, Pagliara E. (2014). Parallel alternating sliding knots are effective for ligation of mesenteric arteries during resection and anastomosis of the equine jejunum. BMC Vet Res, 10 Suppl 1(Suppl 1), S10. https://doi.org/10.1186/1746-6148-10-S1-S10

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 10 Suppl 1
Issue: Suppl 1
Pages: S10

Researcher Affiliations

Gandini, Marco
    Giusto, Gessica
      Comino, Francesco
        Pagliara, Eleonora

          MeSH Terms

          • Animals
          • Horses / surgery
          • Jejunum / surgery
          • Ligation / methods
          • Ligation / veterinary
          • Mesenteric Arteries / surgery
          • Pressure
          • Suture Techniques / veterinary
          • Sutures

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          Citations

          This article has been cited 2 times.
          1. Hurcombe SD, Roessner HA, Klein CE, Engiles JB, Hopster K. Use of Polyamide (Nylon) Cable Ties for Vascular Ligation of Healthy Equine Jejunal Mesentery. Front Vet Sci 2021;8:639424.
            doi: 10.3389/fvets.2021.639424pubmed: 34458347google scholar: lookup
          2. Giusto G, Gandini M. Ex vivo comparison of sliding knot ligatures vs. haemostatic clips for equine small intestinal mesenteric vessel occlusion. BMC Vet Res 2020 Aug 12;16(1):290.
            doi: 10.1186/s12917-020-02498-xpubmed: 32787840google scholar: lookup
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