Tips and Tricks for Mastering Suturing and Knot-Tying During the EMIG Exam (Part One)

INTRODUCTION: In 2023, the laparoscopic surgical skills assessment for the American Board of Obstetrics and Gynecology (ABOG) transitioned from Fundamentals of Laparoscopic Surgery (FLS) to Essentials of Minimally Invasive Gynecology (EMIG). The EMIG exam consists of a manual skills training and testing platform of laparoscopic exercises specific to gynecologic surgery. In this video (Part 1), we demonstrate tips and tricks for mastering the extracorporeal knot-tying task (task 3) of the EMIG exam. OBJECTIVE: The objective of this video is to provide learners with techniques and tips for completing the extracorporeal knot-tying task on the EMIG manual skills examination. The focus of the video is on efficient needle handling, suture management, and instrument ergonomics. METHODS: Techniques for mastering the extracorporeal knot-tying task (Task 3) on the EMIG exam were recorded with views inside and outside of the laparoscopic box trainer. We describe multiple techniques for laparoscopically loading the needle, tips for efficiently driving the needle through the penrose drain, how to use open and closed knot pushers, and include a step-by-step tutorial on how to throw and cinch down the knots. RESULTS: This is an instructional video. CONCLUSIONS: This instructional video can be viewed by learners to master extracorporeal knot-tying and prepare for task 3 of the EMIG manual skills examination.