Laparoscopic method for suturing in a body cavity

A laparoscopic method of tying off sutures in a body cavity comprising the steps of:

• a. inserting a trocar with an annulus through a body wall into a body cavity;
• b. passing a first end of suture down the annulus of the trocar while the trocar is in the body cavity to a first piece and a second piece of internal body tissue in the body cavity while a second end of suture remains outside the trocar;
• c. proximating together the first piece and the second piece of internal body tissue in the body cavity using the first end of the suture;
• d. after passing through the internal body tissue, pulling the first end of the suture back through the annulus of the trocar while maintaining the trocar in the body wall of the internal body cavity;
• e. passing the first end of the suture out through a hole in a laparoscopic knot pushing device;
• f. forming at least one throw for forming a knot around the second end of the suture between a second end of the laparoscopic knot pushing device and the trocar;
• g. simultaneously while holding both ends of the suture together, pushing the at least one throw down through the annulus of the trocar to the first piece and the second piece of internal body tissue using the laparoscopic knot pushing device until the at least one throw is adjacent at least one of the internal body tissues;
• h. withdrawing the laparoscopic knot pushing device from the first piece and the second piece of the internal body tissue while maintaining the trocar in the body wall and maintaining the suture on the laparoscopic knot pushing device;
• i. forming a second throw for forming the knot between the second end of the laparoscopic knot pushing device and the trocar;
• j. simultaneously while holding both ends of the suture together, pushing the second throw down through the annulus of the trocar using the laparoscopic knot pushing device to the first piece and the second piece of internal body tissue until the second throw is on top of the first throw forming the knot;
• and
• k. withdrawing the laparoscopic knot pushing device from the first piece and the second internal body tissues while maintaining the trocar in the body wall, and maintaining the suture on the laparoscopic knot pushing device;
• and
• l. if needed, creating at last one additional throw, pushing of the additional throw down the annulus of the trocar, and withdrawing the laparoscopic knot pushing device until a surgeon determines the knot is secure.