Knot Tying: One-Handed Tie

One-Handed Tie

The one-handed tie is often faster than a two handed tie, and can also be performed while still holding an instrument (such as the needle driver). It is most often performed with the non-dominant hand, so that (for example) a right handed surgeon is holding the needle driver in her right hand while tying with her left. That said, it is helpful to be able to tie one handed with either hand, which gives the surgeons more options when tying in deep holes or at different angles.

The disadvantages of the one-handed tie are that it is more difficult to control knot tension and also that it is more difficult to tie a good square knot. Even when throws are alternated, the throws often stack up on top of each other rather than lying down flat. While it is possible to lay knots down flat and square one-handed, because of the increased difficulty in doing so some surgeons will intentionally forgo a flat, square knot when tying one-handed and will compensate for adding additional throws.

Left-handed One Hand Tie

Right Handed One Hand Tie:

Failure to cross hands, resulting in series of half hitches:

It is more difficult to tie a square knot one-handed. Even when throws are alternated appropriately, it is harder to cross the hands and lay the throws down flat. This results in the throws stacking up on top of each other as a series of half hitches rather than lying down flat and square. While it is possible to lay knots down flat and square one-handed, because of the increased difficulty in doing so some surgeons will intentionally forgo a flat, square knot when tying one-handed and will compensate for adding additional throws.

Self Assessment

Expert Assessment