Extra Corporeal Meltzer's Knot is a modification of roeder's knot. Roeder's knot is 1:3:1 and Melzer's knot is 2:3:2. In this knot 2 hitches three wind and two lock is present. Therefore, Melzer knot is a geometrical modified roeder's knot which was made of all modifications and all data on knot security and loop security of the knot were analyzed. The introduction of the original knot and its applicable modifications paralleled the increase in minimally invasive techniques and the spread of these techniques in all the medical specialties. Roeder loop security depends predominantly on the number of initial turns around the standing part. Its knot security depends on the additional half hitches used to backup the knot after it has been tightened. Only a few of the modifications improved the security of the knot or its previous modifications and one of that is Meltzer's knot.