. Modern surgery, general and operative. Fig. 236.—Method of tying square or reef-knot. Fig. 237.—Method of tying Doyen, when about to tie a thick pedicle, crushes it by means of a verypowerful instrument and then ties a ligature about the crushed and attenuatedarea. The vessels are closed by laceration wide of the ligature and the ligaturedoes not tend to slip. Some trust such a stump without a ligature, but mostsurgeons prefer to ligate. This instrument is known as the vasotribe or angio-tribe and is used particularly in hysterectomy. Figure 242 shows a vasotribe. Veins are lig
. Modern surgery, general and operative. Fig. 236.—Method of tying square or reef-knot. Fig. 237.—Method of tying Doyen, when about to tie a thick pedicle, crushes it by means of a verypowerful instrument and then ties a ligature about the crushed and attenuatedarea. The vessels are closed by laceration wide of the ligature and the ligaturedoes not tend to slip. Some trust such a stump without a ligature, but mostsurgeons prefer to ligate. This instrument is known as the vasotribe or angio-tribe and is used particularly in hysterectomy. Figure 242 shows a vasotribe. Veins are ligated as are arteries. If alarge vein is torn, we wish, if possible, tocontrol hemorrhage without obliteratingthe lumen of the vein by ligation. If thewound is not greater in length than themeasure of the diameter of the lumen, alateral ligature may be used. It is prac-tically always used in small transversewounds. In order to apply a lateral liga-ture the two lips of the vein wound are seized by forceps and drawn out into a tit (Figs. 240 and 258). A ligatureis placed around the base of the cone and tied. The pull in the
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