Referral guidelines for colorectal cancer--do they work?

Historically, tying a knot has played a vital role for man. Knots were useful for many activities such as building bridges, mooring ships; therefore, men in ancient nations, both civilised and tribal were experts at tying a knot.1 In spite of the introduction of tissue adhesives, clips and staples and endoscopic knotting, a hand tied knot remains an essential basic skill that forms part of any surgeon’s armamentarium, regardless of surgical specialty. There are many studies that have evaluated the quality of a tied knot.2,3 To our knowledge, no previous study has investigated the dexterity that is associated with knot tying. The aim of this study was to assess open knot tying at depth between surgeons of differing grades and between two surgical specialties that frequently tie knots at depth (general surgery and urology).