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Similar to open surgery, many knot‐tying techniques are available in laparoscopic suturing. Here we will provide detailed instructions for two alternative techniques used in the VALS curriculum to successfully train a great number of novices.

ssss1 Needle introduction through a right‐sided cannula according to Brody et al. [11](A). The needle is backloaded on the right‐hand instrument (i.e., with the needle tip pointing in toward the shaft of the instrument) and introduced with the convexity to the left at 9 o'clock. (B). Needle visible in the field at the 9 o'clock position. (C). The right instrument is rotated clockwise 90° so the needle convexity now points to 12 o'clock. (D). The left instrument is grasping the needle. (F). The left instrument has grasped the needle with the convexity still 12 o'clock. (F). The left instrument is rotated counterclockwise 180° so the convexity points to 6 o'clock. This technique preferably is used with a needle driver in the right hand and a grasping forceps in the left, as the grasping forceps rotate around the instrument axis, making the 180° turn more ergonomic. (G). The needle can now be grasped at the appropriate position. (H). The needle is positioned for a right‐to‐left suture bite.