Deep Double Ligature

This model uses a stuffed toy dog with two large vessels placed deep inside the abdomen, which is packed with "viscera" (flour-filled and water-filled balloons). The vessels are localised and clamped, before double ligating and transecting.

Materials:

• Stuffed toy dog
• Abdomen: plastic aquarium with metal clips on the inside
• Intestines: 10-20 long balloons (20cm) filled with corn starch or gel
• Bladder: round balloon filled with water
• Vessels: Silicone dental tube, white/red, diameter 2mm and 3,5mm, soft.

Set up:

• Fill 10-20 long and/or irregular balloons with corn starch or gel 
• Fill the round balloon with water so that it’s soft and fluctuating
• Place three silicone tubes in the abdomen, using the metal clips to fix them to the "abdominal wall"
• Fill the abdomen with the abdominal "organs"
• If the vessels are cut after use, replace them

The following supplies should be available at the work station:

• Suture
• Needle holder
• Two medium haemostats
• Scissors

Student instructions:
Perform haemostasis:

• Locate the two abdominal vessels without harming the "viscera" - the vessels are "white" and approx. 4 mm in diameter.
• Double ligate the two vessels, using hand ties on one and instrument ties on the other.
• Do not cut the vessels
• Remove the ligatures after completing the task, so the model is ready for the next student

This resource was developed by Associate Professor Rikke Langebæk at the University of Copenhagen and is cited with her permission.