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Double-Throw Ligature Knot (Instrument Tie): The Surgical Double-Throw knot is a standard ligature used by surgeons. This demonstration shows the knot being tied with forceps.
Double-Throw Ligature Knot (One Handed Technique): The Surgical Double-Throw knot is a standard ligature used by surgeons. This technique shows the end being pulled through the knot.
Double-Throw Ligature Knot (Two Handed Technique): The Surgical Double-Throw knot is astandard ligature used by surgeons. This technique shows the end being pushed through the knot.
Surgical Square Knot (One Handed Technique): The Surgical Square knot is one of the standard ties used by surgeons. This technique shows the end being pulled through the knot.
Surgical Square Knot (Instrument Tie): The Surgical Square knot is one of the standard ties used by surgeons. This demonstration shows the knot being tied with forceps.
Surgical Square Knot (Two Handed Technique): The Surgical Square knot is one of the standard ties used by surgeons. This technique shows the end being pushed through the knot.
Surgical Knots
Introduction: We introduced this section partly to accompany our research on surgical knots showing that the Constrictor is markedly superior to knots usually employed by surgeons1. The paper has generated interest and, as a result, the Royal College of Surgeons has kindly made it Available On Line.
Animations: We show four techniques for tying the Constrictor in Surgery as well as animations for Surgical Ties and Ligatures – all tied from the surgeon's viewpoint. Each animation can be flipped to suit right-handed and left-handed operators or inverted to help an instructor guide a student sitting across a table.
Names: Surgical Ties are commonly described as "One-Handed" or "Two-Handed" – slightly confusing because both techniques involve two hands. We have added the names "Push" and "Pull" based on the way that the end is guided through each knot.
Practical Considerations: A completed surgical knot may be out of sight. So, the technique may create the intended Square (Reef) knot or it may create an unintended stack of Half Hitches. This partly explains the custom of adding multiple extra Half Knots. The Constrictor provides a method of which eliminates this risk.
Reference:
1 Taylor H, Grogono AW. The constrictor knot is the best ligature. Ann R Coll Surg Engl. 2014 (96): 101-105.
