Mastering efficient Cor-Knot skills: novel S technique for solo automated suture fastening

The Cor-Knot (CK) device is a leading automated suture fastening system in wide usage during cardiovascular procedures, such as heart valve surgery. The system comprises essential components such as the shaft, curved handle, wire snare, and crimpable titanium fasteners. While offering a strong, secure, and efficient alternative to hand-tied knots, available techniques for its rapid and professional use (particularly in solo handling) are not well-documented. Many surgeons unintentionally add redundant steps that may reduce device efficiency and instead rely on assistants during the procedure. Herein, we introduce a streamlined approach, or so-called S technique, allowing surgeons to quickly and independently fasten knots using the CK Mini, demonstrated through a video and images. This method is focused on continuous control of the suture material, curved handle, and wire snare to optimize performance. The technique was evaluated using surgical practice tools, emphasizing its potential to enable surgeons to perform procedures solo with enhanced proficiency and minimal reliance on assistants. Our experience indicates that this method can be faster than performing the procedure with an assistant, highlighting its efficiency in time-sensitive operations. As surgical technologies continue to evolve, surgeons should focus on refining their manual skills to maintain efficiency and precision in diverse clinical settings.