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Shunt disconnection is less likely using a surgeon’s knot compared with a surgical constrictor knot

Lookup NU author(s): Dr Gareth Dobson


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© 2020, © 2020 The Neurosurgical Foundation. Introduction: Ventriculo-peritoneal shunt malfunction is a common neurosurgical presentation, which may occur as a result of shunt disconnection at the level of the valve. Previous studies assessing ligatures have suggested that the constrictor knot is stronger in securing a ligature compared to the surgeon’s knot. Our study compared the ability of each knot to secure shunt tubing to the valve. Methods: A medtronic shunt valve was secured to a peritoneal catheter using the surgeon’s knot versus constrictor’s knot. The weight and subsequent force (N) required to pull off the shunt tubing at the knot site were recorded. Results: The mean pull-off force was 11.7 N for the surgeon knot, and 8.9 N for the constrictor knot. There was significant difference in favour for the surgeon’s knot compared to the constrictor knot. Conclusions: The surgeon’s knot is significantly stronger than the constrictor knot for securing a peritoneal catheter to a CSF shunt valve.

Publication metadata

Author(s): Okasha M, Dobson GM, Tsonis I, Hussain M, Ross N

Publication type: Article

Publication status: Published

Journal: British Journal of Neurosurgery

Year: 2021

Volume: 35

Issue: 2

Pages: 216-219

Online publication date: 01/07/2020

Acceptance date: 11/06/2020

ISSN (print): 0268-8697

ISSN (electronic): 1360-046X

Publisher: Taylor and Francis Ltd


DOI: 10.1080/02688697.2020.1782834

PubMed id: 32608285


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