Bowline knot of a monofilament suture eliminates C-loop formation in intracorporeal ligation.

We describe how we developed a new method of tying an intracorporeal suture of monofilament material using a bowline knot, which eliminates the troublesome C-loop formation for winding the thread on the rod. The winding-forceps point to the site of suturing, and the needle end of the thread is placed under the rod of the forceps during the knot tying. This position allows for easy winding of the line even when the forceps-angle is as narrow as 10° because the winding-forceps and suture line are in parallel. This method resolves the problems of C-loop formation with a narrow forceps-angle. Thus, our bowline method of knot-tying provides an easy, secure, and rapid intracorporeal ligation requiring a short learning curve, as an alternative to the conventional C-loop method.