Real-Time Objective Assessment of Knot Quality With a Portable Tensiometer Is Superior to Execution Time for Assessment of Laparoscopic Knot-Tying Performance

Time to complete a knot is a poor metric for the objective assessment of intracorporeal knot-tying performance in the absence of a measure of knot quality. Real-time evaluation of the knot quality can accurately distinguish well-tied knots from poorly tied knots. This mode of assessment should be incorporated into training curriculum for surgical knot tying.