The other day it was relatively slow all around and so I was fortunate enough to sit down with some doctors and doctors-to-be and learned the subtle art of suturing. I’m sure we have all witnessed trained surgeons throwing knots like there’s no tomorrow; however, rather surprisingly there is a lot that goes into even a simply stitch.
So apparently, there are over 1400 different types of knots (or at least according to the Encyclopedia of Knots…who knew there was even such an encyclopedia…shows I was never Eagle Scout extraordinaire). Anyway, despite the plethora of knots, surgeons only use several different ones. The most common are as follows: square knot, surgeon’s knot, deep tie,
instrument tie, running stitch and ligation with a hemostat (a surgical clamp).
The square knot is essentially the same thing as the knot you use to tie your shoelaces, with the exception that, like everything in medicine, you have to make it more complicated than necessary. Similarly, the surgeon’s knot is essentially a double knot. The deep tie is usually used to approximate tissues deep in a cavity. The instrument tie is a quick way to tie a knot by simply wrapping the suture around the needledriver and then using needledriver to pull the other end of the suture through the loop you just made. Both square and surgeon’s knots can be thrown in this manner. The running stitch is just a continuous series of stitches thrown with one suture. I didn’t learn how to do a ligation tie, but I’ve seen it done a few times. It seems like you clamp down a vessel, loop the suture around the hemostat and tie off the vessel behind the clamp with some square knots.
Anyway, this post was not meant to reveal anything profound, I just thought it was an interesting experience to share and some potentially useful knowledge to know…next time I need to tie off my blood vessels I will know…and knowing is half the battle…