Extra Corporeal Mishra's Knot is ideal knot for thick pedicles. We prefer to use a monofilament poly trimethylene carbonate absorbable suture for Mishra's Knot. It is very good knot for uterine vascular bundle, splenic artery, renal artery or In-mass Ligation in cholecystectomy. It combines excellent tensile strength with good handling properties. It has a good first-throw holding capacity and a smooth knot tie-down, which facilitates tissue approximation and reduces intraoperative knot repositioning, despite its relatively high memory. If a Mishra's knot has to be placed extracorporeally, we use a monofilament polypropylene or polygalactane suture as in conventional surgery. We prefer to use coated, braided polyester nonabsorbable sutures in sutured rectopexy also in Mishra's Knot.