Surgical Technique: The Ambidextrous Surgeon’s Knot: An Alternate Way to Tie the Surgeon’s Knot

• Published in: Canadian Journal of Surgery Vol. 50; no. 6; pp. 470 - 471
• Main Authors: Jha, Pankaj K., MS, MRCSEd, Barabas, Anthony G., MRCS, Sharma, Hemant, MS, MRCS
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact Inc 01-12-2007; CMA Impact, Inc; Canadian Medical Association
• Subjects: Continuing Medical Education; Functional Laterality; Humans; Knots; Knots and splices; Methods; Surgeons; Surgery; Suture Techniques; Tissues; Canada
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1016/S0008-428X(07)50150-5

The surgeon's knot is a well-established knot in surgical practice, known to provide unsurpassed grip and security for the tissue tied. It is particularly useful with slippery monofilament suture materials.1 Traditional tying of the surgeon's knot involves a cumbersome technique of repeating throws to complete the double loops of each hitch.2,3 We describe a 2-handed singlethrow technique, which produces the 2 loops of each throw simultaneously. In tying an ambidextrous surgeon's knot, the surgeon must be able to perform an "index finger" and "middle finger" throw with both the right and left hands independently, thus resulting in a much simpler and elegant set of movements. We do not claim that this technique is unique to us, but we hope to popularize it through this article. Pull the strands in opposite directions in a smooth movement to form the first set of double loops of the surgeon's knot. The strands may be regripped with the thumbs while doing this, to provide extra leverage. Push the knot down securely by applying as much horizontal tension as possible (Fig. 5). Pull the strands in opposite directions in a smooth movement to form the second set of double loops of the surgeon's knot. The strands may be regripped with the thumbs while doing this, to provide extra leverage. Secure the knot by applying as much horizontal tension as possible, completing the knot (Fig. 9).