1. Take the stitch with a standard needle holder leaving a 1“ – 2” short
tail on the needle entry side. Grasp the needle end of the suture with an
assisting forceps about 3” – 5” from the operative site to fix the suture.
Trap the suture under the upper jaw of the Easyknot device about
1.5”from the point of suture fixation.

2. Use the assisting forceps to wrap the suture around the Easyknot
device twice, distal to the upper jaw (preferably going first under the
device than over it).

3. Bring both instruments closer to the short tail and hold the tail with the lower jaw of the Easyknot device. Open the upper jaw to release trapped suture and pull the device (holding the suture tail) and assisting forceps (holding the needle suture end) in opposite directions (relative to initial positions) to establish a flat half hitch.Cinch and tighten as needed.

4. Repeat the procedure to form additional half hitches making sure to
reverse the direction of pulling on the suture ends to establish a square
knot. For instance, if the short end starts on the right side of the incision, it should end at the left side after the first half hitch and again on the right side after the second half hitch.