Tying up a pedicle so it can be cut by combining them is facilitated by using ties on passers, and can be performed efficiently by doing the following method.
Step 1. The surgeon will then place an angled clamp underneath the pedicle and opens the jaws after it shows on the other side of the tissue. The nurse then places a tie on a passer, then with your free hand hold taut between and the clamp in the other one, all the way down the angled clamp's jaws. The surgeon grabs the taut portion of ligature with the angled clamp. When grasping a taut segment, as opposed to a free end dangling under the passer, these operators do control the ligature.
Step 2. The surgeon freezes until he sees that the ligature has been released, prior ro pulling through. Pulling and clamping the ligature all in a solo motion prior to it being released results in a torn pedicle that proves both disgraceful to the operators & could be hazardous to the patient.
Step 3. The doctor takes the free ends in one hand, leaving the assistant with both hands free to go pass the second ligature and right into the angled clamp's teeth.
Step 4. The assistant retains the 2nd ligature and ties his side 1st. Light retraction towards the acceptable course of one ligature will help maintain reserve between the two while the other is fixed. Countertraction during tying of 1 ligature can sometimes be aided by grasping the opposite ligature deep in the wound with a surgical instrument and correctively guiding its tension.
To have good distance in between the two ties, the knot tier forms the first half hitch, then before tying it down, places his two index fingers inside the loop. Take the deep portion of the loop then finish it at the appropriate place up against the deep part of the pedicle, and completes the tie. As in vessel ligation with a passer, crossing the segments before tying the 1st 1/2 hitch facilitates flat application, with the best visual performance for both the tier and the assistant.
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