ABSTRACT
Ligatures and suturing techniques represent a safe and, in many cases, the only method of hemostasis in endoscopic surgery and often are better suited than thermal methods. Various suture materials, applicators, and needle holders have been developed for this purpose. Laparoscopic intracorporeal knot tying in minimally invasive surgery requires great manual dexterity. There is a difference between laparoscopic suturing and open or robotic-assisted suturing. Furthermore, a variety of alternatives, including bipolar and ultrasound-based sealing instruments, have replaced intracorporeal ligatures and needle handling. Therefore, the art of suturing also includes the art of proper selection.
