Suture Ligating[edit | edit source]


Step-by-step Procedure to Suture Ligating[edit | edit source]

Attach your glove longitudinally in the plastic container using four binder clips
  • Use one binder clip to attach the wrist of the glove to the plastic container
  • Use an additional binder clip to attach the fourth finger to the opposite end of the plastic container
  • Use another binder clip to attach the fifth finger to the side end of the plastic container
  • Use the last binder clip to attach the second finger to the opposite end of the plastic container
Using a haemostat, clamp the base of the second finger
  • Open the jaws of your haemostat with your dominant hand
  • From the side of the second finger that is closest to you, advance the jaws of the haemostat such that they are perpendicular to the finger
  • Advance the haemostat until the entire width of the finger is enclosed in the jaws
  • Clamp closed the haemostat
    • Ensure that you have clamped the haemostat such that you hear only 1 click
    • There is rarely a time when operating on human tissue that you will need to require more than one click on any surgical instrument
Throw a forehand stitch through the base of the fourth finger, proximal to the haemostat
  • Load your needle driver
  • Holding the needle driver in your dominant hand, pronate your hand
  • Place the needle below the glove
  • Line the needle tip directly below the mid-point of the haemostat that is clamped across the fourth finger
  • Supinate your hand to push the needle through the glove
  • Grasp the needle with forceps
  • Release the needle driver from the needle
  • Reload the needle on the superior surface of the glove by pronating your hand
  • Supinate your hand to pull the needle out of the glove
  • Pull the remaining suture until only a 2 cm tail is left on the inferior side of the glove
Instrument tie a surgical knot
  • Wrap the suture from the superior surface around the needle driver twice
  • Open the jaws of the needle driver and grasp the tail of the suture
  • Pull your knot tight
  • This knot should be placed on the superior surface of the glove
Wrap the running end of the suture around the finger proximal to the haemostat
  • In the operating theatre, you will need to guide your assistant to help you pass the suture
Now, instrument tie
  • The first should be a surgeon’s knot
  • Remove the haemostat that you placed across the finger and continue to tighten your knot
    • In the operating theatre, you will have your assistant slowly remove the haemostat
  • Now tie the remaining number of knots appropriate for the suture material, ensuring they are square knots
Cut the suture with appropriate length tails
  • Ensure the tails are not so short that the knot unravels

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