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

Abstract

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.

Keywords:

• Shunt disconnection
• surgeon’s knot
• constrictor knot

Disclosure statement

No potential conflict of interest was reported by the author(s).