Buzz
Acquiring the skill to tie surgical knots is indispensable for those working in operating rooms. There exist three fundamental methods. Begin your journey by mastering the two-handed technique, known for its simplicity and rapid learning curve. Once proficient, advance to the one-handed or forceps-assisted knot tying methods. Although more challenging to learn, they offer greater speed and efficiency. Remember, proficiency in all three techniques requires diligent practice and patience.
Procedures
Executing a Surgical Knot Using Two Hands
Grasp the short end of the string with your left hand. Orient the short end away from you and secure it between your index finger and thumb. Elevate the string vertically to initiate the knotting process.
- For left-handed individuals, simply reverse the instructions.
Begin by looping the long end over your right thumb. Hold the long end, wrapping it over your thumb and then around your palm. Grip it firmly, resembling how you would hold a bicycle handle. Adjust your hand position so that your thumb faces upward.
Hook your right index finger around the short end. Reach for the lower portion of the short end with your right index finger, drawing it toward you. Bring it close to the long end, preparing for the next step.
Slide your right index finger under the long end. While keeping the short end hooked, place the long end on top of your right index finger.
Secure the short end with your right thumb and index finger. Pull the short end over the long end by moving your left hand closer to you. Hold the short end firmly between your thumb and index finger.
Pass the short end beneath the long end. Rotate your right hand to the right, guiding the portion of the short end you're pinching under the long end draped over your index finger. Maintain your grip on the short end throughout this maneuver.
Tighten the half knot by pulling the short and long ends. Hold the short end with your left hand and the long end with your right hand. Pull them in opposite directions to create a snug half knot.
Create a loop with the long end over your right index finger. Grip the long end like a bicycle handle and extend your index finger. Rotate your hand so that the long end forms a loop over your index finger.
Wrap the short end around your right thumb. As you draw the short end toward the long end using your thumb, release the long end from your index finger and let it drape over your right thumb.
Pinch the short end between your thumb and index finger. Once you've wrapped your thumb with the short end, pull it over the long end and secure it by pinching it firmly.
Thread the short end through the loop around your thumb. While maintaining pressure on the short end with your thumb and index finger, guide it underneath the long end.
Complete the knot by pulling the two ends. After threading the short end through the loop, pull both ends in opposite directions. Draw the long end towards you and the short end away from you. Be gentle to avoid breaking the string.
One-Handed Knot Tying Technique
Hold the short end with your right hand, looped over your index finger. Grip the short end as if holding a bicycle handle. Extend your index finger and rotate your hand to loop the string around it. Keep your other fingers extended behind the string.
Wrap the long end around your right-hand fingers. Start from your middle finger and wrap the long end towards your little finger. Maintain your grip on the short end with your thumb.
Use your right-hand middle finger to guide the long end under the short end. Keep the short end steady by pinching it with your right-hand thumb and index finger. Use your left-hand thumb and index finger to keep the long end taut.
Pass the short end under the long end and tighten. Using your middle finger and thumb, guide the short end under the long end. Then pull both ends in opposite directions to secure your knot.
Loop the short end over your extended index finger. Grip the short end like a bicycle handle, as in the beginning. Extend your index finger and rotate your hand to wrap the short end around it.
Wrap your right index finger around the long end. Secure the long end with your left-hand thumb and index finger. Hold the short end with your right-hand thumb and middle finger.
Pull the short end through the loop around your index finger. Use your middle finger and thumb to guide the short end over the long end. Then rotate your index finger to draw it through the loop.
Tighten both ends. Pulling the ends apart will cinch your knot. Pull the long end away from you and the short end towards you.
Mastering the Instrument Tie
Position forceps perpendicular to the string. Hold the forceps in your right hand, pointing them to the left, just above the string.
Loop the long end around the forceps using your left hand. Pinch the long end with your left-hand thumb and index finger. Then, bring it up, away from you, and over the forceps.
Grasp the tip of the short end with the forceps. Rotate the forceps away from you and toward the short end, ensuring a tight grip.
Pull the short end through the loop around the forceps. After pulling the short end through the loop, tighten by pulling it toward you and the long end away from you. Secure the knot by tightening both ends.
Wrap the long end of the string around your forceps. Hold the forceps in your right hand above and perpendicular to the string. Point the forceps tip to your left. Grab the long end with your left hand, bring it up, over the forceps, and toward you.
Grab the short end tip with your forceps. Rotate the forceps toward the short end, then bring it up and toward the loop around your forceps.
Pull the short end through the loop around your forceps to finish. After pulling the short end through the loop, tighten the knot by pulling the two ends away from each other. Repeat these steps for another knot, or release the short end to finish.
