A single in-person training session using a laparoscopic video trainer is insufficient for teaching the construction of 4S-modified Roeder slip knots.

A single laparoscopic training session is insufficient for novices to achieve proficient 4SModR knot-tying strength.

This prospective experimental study evaluated whether a single in-person training session is sufficient to teach novice Doctor of Veterinary Medicine (DVM) candidates to construct the 4S-modified Roeder (4SModR) slip knot using a laparoscopic video trainer. Conducted from June through August 2022, the study involved novice participants who received written and video tutorials prior to one structured training session led by an intermediate-level DVM candidate with extensive knot-tying experience but no laparoscopic surgical experience. Participants practiced until they achieved four consecutive correctly tied knots. Knots were evaluated biomechanically before and after training, measuring loop holding strength and load at failure. Results demonstrated that post-training novice knots were significantly stronger than pre-training knots in both biomechanical parameters. However, post-training novice knots showed lower failure loads compared to knots tied by the intermediate tyer, indicating that a single session is insufficient to achieve experienced-level proficiency. The two most common errors—particularly the inability to differentiate the loop end from the post end—resulted in significantly weaker knots, with 9 of 12 knots failing at less than 7 N. These findings highlight that laparoscopic intracorporeal knot tying requires substantial, sustained practice beyond a single training session. The authors recommend that veterinary surgical training programs allocate adequate time for trainees to learn, practice, and master these technically demanding knot constructs before performing them in live surgical settings.

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