Ligature Lab Questions Flashcards
Suture is used to “ ___ ___” or _____ an anatomical structure to aid in ______.
Examples of this are:
– ______ _____ (spay)
– ______ _____ (neuter)
– _____ of blood vessels
tie, off, ligate, hemostasis,
Ovarian pedicle
Testicular pedicle
Ligation
Ligature failing is proportional to the _____ of the _____ it encloses
volume, tissue
Don’t forget to ____ _____ vessel/pedicle first and then _______ (cut)
tie off, transect
Circumferential
– Suture is wrapped _____ vessel/pedicle and
secured by tying a ___
– Placed _____ on pedicle
(______ to body)
– Often performed in the ”____” of a clamp
around, knot, proximally, closest, crush
Circumferential - Applications:
– ______ hemostasis
– Ligation of _____ or ____ pedicle
Vascular, ovarian, testicular
Circumferential Steps:
- Pass the free end of the suture around
the vessel or pedicle - Tie a square or surgeons knot followed
by additional secure throws
- Transfixation/Transfixing
– Typically used for _____ vessels or pedicles
– Consists of __ steps and __ knots
– Placed _____ on the pedicle and distal
to ______ ligature - Distal = ____ away from body
larger, 2, 2, distally, circumferential, further
- Transfixation/Transfixing
Applications:
– _____ hemostasis
– Ligation of ____ or ____ pedicle
Vascular, ovarian, testicular
Transfixation/Transfixing
1. Take a small perpendicular bite through the middle of
the pedicle
– Ensure only a small portion of the vessel or the pedicle is
encircled by suture
2. Tie a square or surgeons throw (no additional throws
needed). Make sure to leave a long tag with the non-
needled end of the suture.
3. Wrap tail end of suture (non-needled) around the
entire pedicle and tie to long end (needled) with a
square or surgeons throw. Add additional securing
throws.
- Friction Knots
– Useful for ”_____” pedicles (___) or
when the pedicle is under ____
– Useful for _____ ligation
(OVH/neuter)
– ______ and _____ _____ have greater knot security than Circumferential and Transfixing ligatures
– Commonly used instead of a ______ ligature - Examples?
fatty, spay, tension, vascular, Millers, Modified Millers, circumferential
– Miller’s Knot
– Modified Miller’s Knot
Miller’s Knot 1. Wrap the free end of the suture around the pedicle.
Extend your index finger and lay the suture over your
index finger creating an X
– You can hold the X with your thumb
2. Wrap the suture around pedicle a second time and lay
the ”free end” suture strand to the left of the X
3. Pass the needle drivers underneath the right leg of the X
(created in step 1) and then on top of the left leg of the
X.
4. Grab the free end of suture and bring it on top of the left
leg of the X and underneath the right leg of the X and
pull suture through
– We want the free end of suture to go on top of the left leg of
the X (created in step 1) but underneath the right leg of the
X
5. Tighten first throw with even tension and place 3 simple
Modified Miller’s Knot
– Aka Strangle knot
1. Wrap the free end of the suture around the pedicle. Extend
your index finger and lay the suture over your index finger
creating an X
– You can hold the X with your thumb
2. Wrap the suture around pedicle a second time and lay the
”free end” suture strand in the center of the X that was
created in step 1
3. Pass the needle drivers underneath the right leg of the X and
grab the free end of the suture and pull through
4. Tighten first throw with even tension and place 3 simple
throws on top to secure the knot
Modified Miller’s Knot
– Aka _____ knot
Strangle
- “Crush”
– Hemostat is placed on _____ or ____ and used to _____ tissue
– Hemostat is then removed and ligature is placed in “_____”
pedicle, vessel, crush, crush
- “Flashing”
– Hemostat is placed on pedicle or vessel and then ______ while first __ throws of ligature are placed
loosened, 2
