The Uni Angler Knot: A Novel Self-lock Sliding Surgical Knot.

Achieving secure knotting in narrow surgical fields or in high-tension suturing situations remains a technical challenge. Conventional square and surgeon's knots often require an assistant to maintain tension during tying and multiple hitches to ensure security, resulting in bulky knots. To address these limitations, we introduced the uni angler knot (UAK), a novel single-strand, self-locking sliding knot based on the original fishing knot described by angler and fishing writer Norman Duncan as the "universal knot." The UAK is designed to preserve suture tension during tying and to ensure secure fixation with minimal handling. It has been successfully applied in selected plastic surgery procedures, including septal stabilization in rhinoplasty, fascial plication in abdominoplasty, and parenchymal support in breast surgery. Its reproducibility and suitability for confined operative fields are demonstrated through step-by-step illustrations and procedural videos. The UAK provides an effective technique for achieving consistent knot security in demanding surgical conditions and may be particularly advantageous when conventional knots are technically unfeasible or when surgical assistance is limited.