Use of the TI-Knot device is safe, faster, and easier alternative to the hand-tying in the repair of the large hiatal defect
EAES Academy. Bjelovic M. 07/05/22; 366548; P291
Prof. Dr. Miloš Bjelovic
Contributions
Contributions
Abstract
There are two main technical causes of recurrent hiatal hernia: unrecognized secondary short esophagus and insufficient hiatal closure. Primary posterior or retroesophageal cruroraphy has been the mainstay of practice for many years in hiatal hernia repair. To avoid tension on the suture line in cases of a large or round-shaped hiatal defect, in mixed (type III) and in giant PEHs, plication of the left pillar should be performed. The aim of this widely accepted technique is to loosen the tension on the pillars as much as possible. Nevertheless, in the case of the fibrotic crura, or significant bowing of the left pillar, tension is a real issue and hand tying could be challenging and cause additional tissue damage.
The Ti-KNOT Device (LSI SOLUTIONS®, Victor, New York) offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying.. Its strength, security, and reliability have been previously confirmed in different laparoscopic procedures, including hiatal closure. Back in 2003, Davis R described the technique where the crural defect was closed using interrupted 0 Ethibond sutures and secured with the Ti-KNOT. In 2017, Banki F published experience with the use of Ti-KNOT in hiatal hernia repair on more than 200 cases.
The Ti-KNOT has a shaft5 mm in diameter and 31 cm in length, which is optimized for remote suture fastening during minimally invasive procedures. An ergonomic lever enables surgeons to crimp the Ti-KNOT titanium fastener while trimming and cutting the suture, all in one easy squeeze (one squeeze technology). It has been available and in standard use in the US market for many years; CE mark approval was granted recently. It’s expected that the use of Ti-KNOT will be cost-effective compared to hand tying hiatal closure, but this has to be proven with large-scale randomized control trials.
In conclusion, The Ti-KNOT Device offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying. Its strength, security, and reliability were previously confirmed in different laparoscopic procedures, including difficult hiatal closure.
The Ti-KNOT Device (LSI SOLUTIONS®, Victor, New York) offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying.. Its strength, security, and reliability have been previously confirmed in different laparoscopic procedures, including hiatal closure. Back in 2003, Davis R described the technique where the crural defect was closed using interrupted 0 Ethibond sutures and secured with the Ti-KNOT. In 2017, Banki F published experience with the use of Ti-KNOT in hiatal hernia repair on more than 200 cases.
The Ti-KNOT has a shaft5 mm in diameter and 31 cm in length, which is optimized for remote suture fastening during minimally invasive procedures. An ergonomic lever enables surgeons to crimp the Ti-KNOT titanium fastener while trimming and cutting the suture, all in one easy squeeze (one squeeze technology). It has been available and in standard use in the US market for many years; CE mark approval was granted recently. It’s expected that the use of Ti-KNOT will be cost-effective compared to hand tying hiatal closure, but this has to be proven with large-scale randomized control trials.
In conclusion, The Ti-KNOT Device offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying. Its strength, security, and reliability were previously confirmed in different laparoscopic procedures, including difficult hiatal closure.
There are two main technical causes of recurrent hiatal hernia: unrecognized secondary short esophagus and insufficient hiatal closure. Primary posterior or retroesophageal cruroraphy has been the mainstay of practice for many years in hiatal hernia repair. To avoid tension on the suture line in cases of a large or round-shaped hiatal defect, in mixed (type III) and in giant PEHs, plication of the left pillar should be performed. The aim of this widely accepted technique is to loosen the tension on the pillars as much as possible. Nevertheless, in the case of the fibrotic crura, or significant bowing of the left pillar, tension is a real issue and hand tying could be challenging and cause additional tissue damage.
The Ti-KNOT Device (LSI SOLUTIONS®, Victor, New York) offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying.. Its strength, security, and reliability have been previously confirmed in different laparoscopic procedures, including hiatal closure. Back in 2003, Davis R described the technique where the crural defect was closed using interrupted 0 Ethibond sutures and secured with the Ti-KNOT. In 2017, Banki F published experience with the use of Ti-KNOT in hiatal hernia repair on more than 200 cases.
The Ti-KNOT has a shaft5 mm in diameter and 31 cm in length, which is optimized for remote suture fastening during minimally invasive procedures. An ergonomic lever enables surgeons to crimp the Ti-KNOT titanium fastener while trimming and cutting the suture, all in one easy squeeze (one squeeze technology). It has been available and in standard use in the US market for many years; CE mark approval was granted recently. It’s expected that the use of Ti-KNOT will be cost-effective compared to hand tying hiatal closure, but this has to be proven with large-scale randomized control trials.
In conclusion, The Ti-KNOT Device offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying. Its strength, security, and reliability were previously confirmed in different laparoscopic procedures, including difficult hiatal closure.
The Ti-KNOT Device (LSI SOLUTIONS®, Victor, New York) offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying.. Its strength, security, and reliability have been previously confirmed in different laparoscopic procedures, including hiatal closure. Back in 2003, Davis R described the technique where the crural defect was closed using interrupted 0 Ethibond sutures and secured with the Ti-KNOT. In 2017, Banki F published experience with the use of Ti-KNOT in hiatal hernia repair on more than 200 cases.
The Ti-KNOT has a shaft5 mm in diameter and 31 cm in length, which is optimized for remote suture fastening during minimally invasive procedures. An ergonomic lever enables surgeons to crimp the Ti-KNOT titanium fastener while trimming and cutting the suture, all in one easy squeeze (one squeeze technology). It has been available and in standard use in the US market for many years; CE mark approval was granted recently. It’s expected that the use of Ti-KNOT will be cost-effective compared to hand tying hiatal closure, but this has to be proven with large-scale randomized control trials.
In conclusion, The Ti-KNOT Device offers an atraumatic, safe, and potentially faster and easier alternative to hand-tying. Its strength, security, and reliability were previously confirmed in different laparoscopic procedures, including difficult hiatal closure.
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