Lesson 1 Two Handed Ties

In this lesson, students will learn the fundamental techniques required to perform a secure and reproducible two-handed surgical square knot.

By the end of this lesson, you should be able to:

1. Demonstrate proper hand positioning and identify the roles of the dominant and nondominant hands during two-handed knot tying.

2. Perform both forehand and backhand throws, using coordinated finger movements to manipulate the suture.

3. Alternate the direction of successive throws to construct a square knot rather than a granny knot.

4. Maintain appropriate suture tension while advancing each throw, ensuring the knot lies flat without excessive tension.

5. Identify and correct common technical errors, including crossed strands, uneven tension, and improper hand movements.

6. Tie a complete surgical square knot with consistent technique, controlled movements, and appropriate knot security.

The goal is to develop the coordination, precision, and muscle memory necessary for reliable surgical knot tying through deliberate, repeated practice.