Transfixed Ligature

This model uses a toy dog with an artificial uterus and uterine vessels placed in the abdomen. Using needle and suture, a transfixed ligature is placed through the wall of the uterus (serosa) and around two vessels – one at a time.

Materials:

• Toy dog
• Uterus: wound dressing (e.g. Allevyn), 4mm
• Condom
• Vessels: Silicone dental tube, white, diameter 2mm, soft.
• Abdomen: rubber bowl (dog feeding bowl)
• Metal clips

Set up:

• Make a 15cm long roll of Allevyn, diameter approx 3.5cm. Hold the roll firmly using agraffs
• Glue a silicone tube (15cm) on each side of the Allevyn "uterus"
• Cover the uterus with the condom, incorporating the vessels and thereby further fixing them to the ‘corpus’. 
• Place the uterus+vessels in the abdomen, using the metal clips

The following supplies should be available at the work station:

• Needle holder
• Suture 
• Needle
• Scissors

Student instructions:
Perform haemostasis:

• Make a transfixed ligature on the uterine vessels running along the corpus uteri.
• Insert the needle through the serosa (and subserosa) close to the vessel and go ‘underneath’ the vessel
• Tie a knot encircling the vessel
• Remember to use your fingers when tying the first (two) throw(s)
• Remove the ligature 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.