Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
London NW3 2QG, UK

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New "Easy Load" Universal Knot Pusher developed at the Royal Free - click here.

A new website for gynaecologists interested in the surgical management of fibroids is now on line.

Weston clinch knot

The Weston knot was described by Dr. Peter Weston, a gynaecologist working in San Antonio in Texas, USA in 1991. The knot was not originally designed to be used at laparoscopy, but has been adopted by endoscopic surgeons as a very elegant slip knot.

This video shows a Weston knot being tied. Note the double half-hitches at the beginning but we only use a single half-hitch at the end for locking. As with the Roeder knot, we usually use vicryl sutures (2/0 to 1) depending on the tissue being sutured. However, as the Weston needs a longer lengths of suture outside the abdomen, we tend to use it less than the Roeder knot.

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There is an inverse relationship between a surgeon's ability and the frequency he asks for muscle relaxant.