The Two Handed Tie

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The Two Handed Tie
Dr.Tribbles Techniques

• University of Virginia Cabell Society

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• Start with suture as illustrated above. The
  suture has been highlighted in red and blue to
  help make things clear.

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Next, cross the suture that was in your right
hand over to the left, so now the suture in your
left hand crosses over the top of the suture that
is in your right hand.
4
Note the manner in which the suture is held in
the left hand. Hold it taut so the suture wraps
around the back of your index finger
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Now place your hands in this position, with the
right hand holding the suture directly towards
you.
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Next, without moving your left hand, swing the
suture in your right hand up, crossing it over
the suture on your left index finger.
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Pinch your left index finger together with the
thumb. Note that it is important to have a good
hold on the suture with the other three fingers
of your left hand (see earlier pictures for how
to do this).
8
Push your pinched index finger and thumb up
through the hole in between the two sutures.
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Without moving your left hand, bring the suture
into the slot made by your left index finger and
thumb and pinch hold of it.
10
Let go of the suture with your right hand, push
the suture back DOWN through the hole, and grab
the suture tail again with your right hand
(ending in this position).
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Pull the two ends of the suture, setting the knot
down flat.
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Holding the left end of the suture taut in
fingers 3-5 and leaving your thumb and index
finger free, bring thumb up under the suture.
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Without moving your left hand, cross the suture
in your right hand over your left thumb
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Pinch the tips of your fingers together
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Without moving your right hand, bring pinched
tips of fingers down through the made by the two
sutures.
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Pinch hold of the suture held in your right hand
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Push the suture back up through the hole and grab
the end with your right hand.
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Cross hands to square the knot.