Study Objective: Demonstrate the techniques for performing an extracorporeal knot tie using both an open and closed knot pusher.

Design: Surgical skills exam training video

Setting: Academic center

Patients or Participants: Obstetrics and gynecology residents taking Essentials of Minimally Invasive Gynecologic Surgery (EMIGS) exam.

Interventions: Instructions for learners regarding the hand motions necessary to tie extracorporeal knots outside of the EMIGS trainer boxes and to push down the knots with both an open and closed knot pusher.

Measurements and Main Results: EMIGS, which was designed specifically to train and evaluate residents on minimally invasive skills required for gynecologic surgery procedures, has become a preferred training platform for many residency programs given its GYN specific skills and cognitive materials. However, the cognitive skills videos listed on the AAGL EMIGS website currently lack instructions for learners regarding the hand motions necessary to tie extracorporeal knots thus creating an educational gap. This video intends to serve as a supplemental tutorial for learners on how to perform an extracorporeal knot with a focus on the hand motions required outside of the box to complete this skill. We highlight the steps necessary to tie the extracorporeal knots using both an open-ended and a closed-ended knot pusher.

Conclusion: Tying extracorporeal knots for the EMIGS exam can be done with both open and closed ended knot-pushers. The steps to tie these knots outside of the EMIGS trainer box can be demonstrated and learned with these supplement instructions currently lacking on the AAGL EMIGS website.