One Handed Knot

Tying a One Handed Surgeon Knot
John Denner One Handed Knot Tying

Things to Keep In Mind 

John Denner

A close friend from Connecticut training  was showing to be a doctor showed me this amazing knot he was learing called, A One Handed Surgeon’s Knot.  The surgeon’s knot, which is looping the suture twice in the same direction before locking it, is generally used when tying under tension as it prevents slippage. You generally want to use the least amount of suture necessary for a secure knot.

The description of this knot is a bit decieving as you need Two Hands to do it.

I thought it was pretty interesting so I’m sharing it here on Random Topics.  Afterall what could be more random than learning How to Tie a One Handed Surgeon Knot.

John Denner 

Boston University School of Medicine and Surgery

One Hand Tie – One Hand Square Knot

Wayne W. LaMorte, M.D., Ph.D., M.P.H.

Photography by Michael J. LaMorte

Two hand ties are generally preferred by most surgeons, but one hand ties can also be used.

For More Info Visit Boston School Of Medicine and Surgery

John Denner One Hand Knot Lesson


First Step in tying a One Handed Knot

1) Note that the short end has been placed beneath the tubing and is held in the right hand, away from the surgeon. The long strand is held in the left hand.

John Denner One Hand Knot Lesson


Second Step in tying a One Handed Knot

2) The right index finger initiates formation of the first loop by pushing the short strand to the left and above the long strand. The left hand begins to move the long strand to the right.


John Denner One Hand Knot Lesson


Third Step in tying a One Handed Knot

3) The right index finger is shown inserted into the loop that has been created. Clearly you have to use Two Hands to Tie a One Handed Knot.


John Denner One Handed Knot Lesson


Fourth Step in tying a One Handed Knot

4) The right index finger now begins to roll behind the short strand, which is still being grasped by the thumb and middle finger.


John Denner One Hand Knot Lesson


Fifth Step in tying a One Handed Knot

5) The end of the short strand has now been released by the right thumb, and the index finger is being used as a lever to rotate the short end up through the loop.


John Denner One Hand Knot Lesson


Sixth Step in tying a One Handed Knot

6) As the short end emerges from the loop, the middle finger pinches it against the forfinger to re-grasp it.

John Denner One Hand Knot Lesson


Step Seven in tying a One Handed Knot

7) And the throw is tightened by pushing the long strand away… and pulling the short strand toward the surgeon with equal tension. Note that tension is applied by pulling the two strands in opposite directions at an angle of 180 degrees.


John Denner One Hand Knot Lesson


Step Eight in tying a One Handed Knot

8) As the second throw is initiated, the short end is toward the surgeon and is being grasped by the thumb and index finger.


John Denner One Hand Knot Lesson


Step Nine in tying a One Handed Knot

9) The right index finger and thumb continue to grasp the short end, as the middle and ring fingers are placed behind the short end to begin creating a loop. The left hand has begun to bring the long strand toward the surgeon.

10) The right hand has supinated slightly …

11) … as the left hand brings the long strand toward the surgeon and across the short strand to form a loop.

12) The right middle finger has now been flexed so it can slide behind the short strand.

13) The right middle finger is now behind the short strand, which is still being grasped by the thumb and index finger.

14) The right middle finger is now used as a lever to rotate the short end away from the surgeon.

15) The short ended is released by the thumb, but the ring finger pinches the short end inside the loop by squeezing it against the middle finger.

As you can see here, tying a One Handed Sugeons Knot is an involved process.  If you are interested learning more about this topic visit the link below.  – John Denner 

One Hand Tie Continued 

Square vs Slipknot


Square  vs Slipknot

Square knot refers to tying in opposite directions to lock a knot. It also refers to laying down a throw squarely. You can see a demonstration of these concepts in the videos linked above.

Slipknot is when you throw two throws in the same direction. This allows you to secure it without locking, helping you prevent air knots.



Efficiency is the name of the game in the operating room. All your movements should be deliberate and intentional. A mistake I often see is tying a one-handed knot while moving your post (stationary hand). This defeats the purpose of a one handed knot.

Once you get the hang of tying, focus on details like eliminating unnecessary movements and not tugging too hard. If you’re tying over a delicate vessel, you need to be able to tie a knot securely without damaging vital structures.

Practice! I would have ties on my water bottle or notebook and tie while watching TV or listening to lectures. Do what works best for you. Practice with both hands. Being able to tie one- and two-handed with either your left or right hand will serve you well in the OR.


Back to the Random Topics

John Denner Blog

The John Denner Blog featuring the People, Places and Hitory of All Things Denner

Denner Family Tree

Genealogical data can be represented in several formats, for example as a pedigree or ancestry chart. Family trees are often presented with the oldest generations at the top and the newer generations at the bottom. An ancestry chart, which is a tree showing the...

read more

Wayne Denner

The Digital Ninja Speaker, Author and Trainer, Wayne Denner has spent over 21 years in the digital space using social media, smart phone tech and the internet to his advantage. This Digital Ninja speaks to 50,000 students (and their parents) & Businesses every...

read more

Denner Recipes, Tips and Tricks

Meet Food Blogger Zoe Torinesi Looking for fresh ideas for a cozy dinner or just looking for something new? Well-known food blogger Zoe Torinesi of Denner Market inspires you every week with exciting but simple creations and useful kitchen tips and tricks for little...

read more

John and Kate Music

Meet the Denner's John Denner (Piano) and Kate Denner (Vocals) met almost a decade ago and were married on August 21, 2011. Almost immediately, they set out in full-time missionary work. The Denner's are both professional musicians and chose to use their music as a...

read more

Hand Crafted Recoders

Denner Edition Alto recorder after Jacob Denner (Denner-Edition 442) These Amazing Hand-crafted baroque recorders are at the Top of the Class among baroque alto recorders at modern pitch. Highest soloistic demands The basis of the historical bore shape are concepts...

read more

Denner Ensemble

Since its formation in 2001, the Denner Ensemble has had nothing but praise for its uplifting, energetic and engaging performances from music clubs, theatres, museums and festivals throughout the United Kingdom. The Music Ensemble are inspired by the famous Besozzi...

read more

Follow John Denner on Social Media