The Vale knot: an intracorporeal slipknot.

Mastering intracorporeal ligation and suturing is an essential skill for the performance of most advanced endoscopic surgical procedures. Although many disposable instruments have become available for various tasks necessitating the construction of sutures and knots; issues of performance, safety, and cost-efficiency remain to be settled. The authors believe that training should aim at the development of manual skills that could realize the clinical and cost-efficiency benefits of using conventional surgical tasks in the endoscopic setting.