1. One Hand Tie - Step 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.

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

3. One Hand Tie - Step 3 The right index finger is shown inserted into the loop that has been created.

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

5. One Hand Tie - Step 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.

6. One Hand Tie - Step 6 As the short end emerges from the loop, the middle finger pinches it against the thumb to re-grasp it.

7. One Hand Tie - Step 7 … 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. And the throw is tightened by pushing the long strand away...

8. One Hand Tie - Step 8 As the second throw is initiated, the short end is toward the surgeon and is being grasped by the thumb and index finger

9. One Hand Tie - Step 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. One Hand Tie - Step 10 The right hand has supinated slightly...

11. One Hand Tie - Step 11... as the left hand brings the long strand toward the surgeon and across the short strand to form a loop.

12. One Hand Tie - Step 12 The right middle finger has now been flexed so it can slide behind the short strand.

13. One Hand Tie - Step 13 The right middle finger is now behind the short strand, which is still being grasped by the thumb and index finger.

14. One Hand Tie - Step 14 The right middle finger is now used as a lever to rotate the short end away from the surgeon.

15. One Hand Tie - Step 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.

16. One Hand Tie - Step 16 The short end is now drawn through the loop away from the surgeon by the middle and ring fingers.

17. One Hand Tie - Step 17

18. One Hand Tie - Step 18 As the short end moves through the loop, the thumb squeezes it against the middle finger.

19. One Hand Tie - Step 19 … as the left hand pushes the long strand away to secure the second throw. Finally, the short end has been re- grasped with the right hand and pulled toward the surgeon...

20. One Hand Tie - Step 20 The 3rd throw is initiated in the same way as the 1st throw, by pushing the short end to the left with the right index finger.

21. One Hand Tie - Step 21 The left hand brings the long strand to the right, beneath the short end.

22. One Hand Tie - Step 22 The right index finger is inserted into the loop that has been created.

23. One Hand Tie - Step 23 And the right index finger rolls behind the short end in order to rotate it up through the loop.

24. One Hand Tie - Step 24 The short end has emerged from the loop and has been re-grasped by the right hand.

25. One Hand Tie - Step 25 And the 3rd throw is secured by pulling the short strand toward the surgeon, as the long strand is pulled away at an angle of 180 degrees.

26. One Hand Tie - 1st Throw (animated)

27. One Hand Tie - 2nd Throw (animated)

28. One Hand Tie - Complete (animated)