What factor most influences knot security in intracorporeal suturing?

What factor most influences knot security in intracorporeal suturing?

• A. Adequate needle passage, proper tissue capture, and appropriate tension.
• B. Suture color and length.
• C. Camera brand and setup.
• D. Surgeon's height.

Answer: (A)

Knot security in intracorporeal suturing primarily comes from how well the tissue is engaged and how the knot is tightened. Adequate needle passage ensures a strong, full-thickness bite and avoids tissue tearing or insufficient capture. Proper tissue capture means you include enough tissue in each bite to create enough friction and compressive force when the knot is tied, so the suture strands grip rather than slip. Appropriate tension is the balance that makes the knot bite snug without crushing tissue; too little tension leaves the knot loose and prone to unravel, while too much tension can damage tissue and alter the knot’s grip. When these elements are executed well, the knot holds under physiological loads.

Suture color and length don’t affect the mechanical security of the knot, camera brand or setup doesn’t change knot strength, and a surgeon’s height has no bearing on the knot’s ability to resist untying. The security comes from technique—the way the needle is passed, the tissue captured, and the tension applied.