Qudsia’s Sneaky Knot: A Practical Modification for Surgical Knot-Tying in Constrained Operative Fields
DOI:
https://doi.org/10.54112/bcsrj.v7i5.2283Keywords:
Clinical Competence, Internship and Residency, Patient Safety, Suture Techniques, Surgical Procedures, OperativeAbstract
Surgical knot-tying is a core operative skill that influences wound security, hemostasis, and patient safety. In clinical practice, conventional knot-tying may become difficult when suture ends are relatively distant or operative access is limited. Objective: To introduce and evaluate Qudsia’s Sneaky Knot, a modified knot-tying technique designed for situations in which conventional approximation of suture ends is technically challenging. Methods: This cross-sectional survey was conducted among 22 Obstetrics and Gynecology residents in a surgical training setting at CMH hospital, Lahore, from June 2023 to June 2024. Participants were introduced to Qudsia’s Sneaky Knot and then assessed using a structured five-point Likert-scale questionnaire. The questionnaire evaluated perceived surgical utility, practicality, ease of learning, safety and confidence, reproducibility, and suitability for inclusion in surgical skills training. Agreement was defined as a Likert score of ≥4. Data were analyzed using descriptive statistics, including mean, standard deviation, frequency, and percentage. Results: All 22 residents completed the survey. Mean domain scores ranged from 4.55 to 4.80 out of 5, indicating consistently high acceptance of the technique. Ease of learning received the highest mean score (4.80 ± 0.39), with 100% participant agreement. Safety and confidence scored 4.69 ± 0.46, while practicality and efficiency scored 4.63 ± 0.51. All participants reported willingness to recommend the technique and to use it independently in future surgical procedures. Conclusion: Qudsia’s Sneaky Knot showed high perceived acceptability, ease of learning, practicality, and educational value among Obstetrics and Gynecology residents. The technique may be useful in constrained surgical situations where conventional knot-tying is difficult. Further validation through simulation-based assessment and comparative operative studies is recommended before wider integration into surgical training curricula.
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Copyright (c) 2026 Qudsia Nawaz, Fatima Shah Muhammad, Shazia Shakeel, Uzma Gul, Samia Rehman, Ayesha Tanveer, Neha Tanveer
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