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This knot is in our opinion easier to tie and with less risk for air in the knot, than the 4SMR. When we used it tied with 2‐0 polyglactin 910 for ovary pedicle ligation in 16 dogs, it was secure without added throws (data to be published). However, the surgeon needs to ensure the knot is correctly tied and avoids air knots. We use this knot also for hand tied ligature loops, again in polyglactin 910, which greatly reduces the cost compared to commercially available loops.

The Weston knot has been advocated as the knot of choice [20] for ease of tying. However, it requires three added throws for security. The Weston knot tumbles and locks when tension is applied to the (short) loop end and therefore needs to be cinched without any tension on the loop end. Most often the added throws are made with intracorporeal technique, which may be a disadvantage to this knot if intracorporeal space is limited.

The modified Roeder as discussed above is these authors' preferred slip knot in clinical MIS. In our experience, it is less complex, with less risk of air knots, than the 4SMR. We have used it without complications for ovarian pedicle ligation in live dogs, without the need for added throws.