-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
How to use a ligating reel?
Started by CBG23
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
You release the end of the suture from the reel, pull it out, hold the reel in the palm of your non dominant hand, wrap the suture around whatever you wish to ligate and tie just like you would with any other suture.
Advertisement - Members don't see this ad
This was an incredibly helpful post. Thank you!
Addendum: you seem to be playing the role of the grumpy old surgeon on these boards based on your prior posts. Good for you,
Last edited:
Thanks for the reply. How do you cross the ends before tying without releasing the reel itself?
Last edited:
One-handed tie.
In order to do a one-handed tie, you would use your dominant hand and NOT cross the suture prior to throwing down the knot though - in order to keep the reel in your non-dominant hand. Is that correct?
I'm a righty. I tie one-handed with my left. Imagine the reel is any other "non-free" end (i.e. tonsil, needle w/ needle driver, etc.).
- Reel in right hand.
- Pass around clamp from right to left hand while holding free end with right.
- Pull out requisite amount of suture while passing, then exchange hands.
- The previous two steps, when done right, appear fluid. The reel should now be in right with free end in left and strands crossed to allow one-handed tie.
This is actually different than how I use free ties, as I don't pass the tonsil around the clamp.
And not to put too fine a point on it, but by you saying that this happens every 8-12 months you must be further along in training. At this point, you should honestly be able to bring home a reel and figure out how this "works". I try to teach my interns that the biggest mistake people make is to learn how to do things like tying (which then extends to other more advanced technical skills) one way, and not bother understanding why it's done that way. That works for medical students and interns, but the reality is that you often get into situations where that way might not work. Understanding the why lets you adapt to the situation. Sticking with tying, understanding how the knot is formed, and what makes a square knot allows you to tie with either hand and start with either one of the throws depending on how it's setup. But approaching it as "I must tie with this hand, with the strands in this configuration" is unnecessarily limiting.
- Reel in right hand.
- Pass around clamp from right to left hand while holding free end with right.
- Pull out requisite amount of suture while passing, then exchange hands.
- The previous two steps, when done right, appear fluid. The reel should now be in right with free end in left and strands crossed to allow one-handed tie.
This is actually different than how I use free ties, as I don't pass the tonsil around the clamp.
And not to put too fine a point on it, but by you saying that this happens every 8-12 months you must be further along in training. At this point, you should honestly be able to bring home a reel and figure out how this "works". I try to teach my interns that the biggest mistake people make is to learn how to do things like tying (which then extends to other more advanced technical skills) one way, and not bother understanding why it's done that way. That works for medical students and interns, but the reality is that you often get into situations where that way might not work. Understanding the why lets you adapt to the situation. Sticking with tying, understanding how the knot is formed, and what makes a square knot allows you to tie with either hand and start with either one of the throws depending on how it's setup. But approaching it as "I must tie with this hand, with the strands in this configuration" is unnecessarily limiting.
Thanks for your explanation and advice. Appreciate you taking the time to post
You can also do it two handed by just letting out enough suture to cross the ends. continue to palm the reel and cut the suture away from the loose and the reel end; either way is fine.
Cool. Thank you,
Not at all.
Smurfette
Gargamel always had a thing for blondes.
Staff member
Administrator
Volunteer Staff
20+ Year Member
You're not the only one. I'm kind of curious now, I'll have to ask if my hospitals even stock it.
I have only had one or two attendings at the VA that used these. I think they are more cumbersome than anything else. Isn't any faster than multiple free ties.
Advertisement - Members don't see this ad
Huh...we had them during residency and I recall using them frequently, although I cannot recall with whom/what cases. But I totally agree that it wasn't all that great. Ours were reels of Vicryl, an Ethicon product IIRC.
Nooooope
It took me like 6 posts before I started to realize the thread wasnt a joke, like a snipe hunting thread.
Also had no idea what this was. **shrugs**
Never used one of these before. But I think I've seen certain specialties (like ENT) use them.
We used them on trauma with a couple of old school surgeons. It's supposed to be faster when you are quickly clamping and tying bleeders.
My FIL (colorectal) uses chromic spools and stats to take mesenteric vessels. it's really weird but cheaper than opening a Ligasure (or whatever) like most of his colleagues.
he's clearly old school.
he's clearly old school.
Similar threads
