Congratulations and kudos! This is the best demonstration of how to tie these four different knots and how their final configurations differ from one another than anywhere I've looked. An article in the Journal of Surgical Education a few years back by a veterinary surgeon and a human anesthesiologist pretty conclusively demonstrated that the constrictor knot has far better holding properties than any of the other knots until you can get those subsequent throws on to secure it. There is a great animated post by one of the authors demonstrating an instrument tie of the constrictor knot here on CZcams. It seems a little daunting until you get the hang of it and then it is really easy to consistently do. Thanks again for posting!
OMG, I have been in practice for 8 years and have always struggled with Miller's vs Modified Miller's. I gave up and would throw a circumferential followed by a transfixing on pedicles. This video made it SO easy to understand. THANK YOU!!!!!
Thank you sir for the clear explanation. Finally I think I got it.So I have been doing the modified Miller's instead of the Miller's knot in my spays...
Happy to help, I don't know why I struggled with these knot conceptually, but for some reason, it took a long time for it to click. I'm so paranoid with my knots, and I was taught to ligate before transecting... I spent too much time trying to work my instruments around the tissues I had exposed when tying knots. I shadowed a colleague at a high volume spay & neuter clinic who always transected before ligating. Two clamps proximal to the ovarian body and one distal, transect, ligate. I've found it's easier to tie a good knot on your hemostat and slide it down onto the pedicle before securing, if the tissue isn't overly friable. I'm a little envious of the shelter med folks, it almost takes them longer to re-glove, scrub, and drape their patients than it does to do the actual procedure!
1:15 strangle knot
2:43 constrictor knot
4:05 miller’s knot
5:13 modified miller’s knot
Thank you a lot!
i've trained Miller's knot and Modified Miller's knot
Congratulations and kudos! This is the best demonstration of how to tie these four different knots and how their final configurations differ from one another than anywhere I've looked. An article in the Journal of Surgical Education a few years back by a veterinary surgeon and a human anesthesiologist pretty conclusively demonstrated that the constrictor knot has far better holding properties than any of the other knots until you can get those subsequent throws on to secure it. There is a great animated post by one of the authors demonstrating an instrument tie of the constrictor knot here on CZcams. It seems a little daunting until you get the hang of it and then it is really easy to consistently do. Thanks again for posting!
Best explanation I've ever seen. Thank you.
OMG, I have been in practice for 8 years and have always struggled with Miller's vs Modified Miller's. I gave up and would throw a circumferential followed by a transfixing on pedicles. This video made it SO easy to understand. THANK YOU!!!!!
Very easy to understand and see! Awesome video!!!
Thank you sir for the clear explanation. Finally I think I got it.So I have been doing the modified Miller's instead of the Miller's knot in my spays...
Me too. :)
Happy to help, I don't know why I struggled with these knot conceptually, but for some reason, it took a long time for it to click. I'm so paranoid with my knots, and I was taught to ligate before transecting... I spent too much time trying to work my instruments around the tissues I had exposed when tying knots. I shadowed a colleague at a high volume spay & neuter clinic who always transected before ligating. Two clamps proximal to the ovarian body and one distal, transect, ligate. I've found it's easier to tie a good knot on your hemostat and slide it down onto the pedicle before securing, if the tissue isn't overly friable. I'm a little envious of the shelter med folks, it almost takes them longer to re-glove, scrub, and drape their patients than it does to do the actual procedure!
Talk talk talk talk. Nut up or don't knot! Lol
So brıef, thanks.. 🙏🏻