In surgery or medical procedure, a ligature consists of a piece of thread ( suture) tied around an anatomical structure, usually a blood vessel, another hollow structure (e.g.

urethra The urethra (: urethras or urethrae) is the tube that connects the urinary bladder to the urinary meatus, through which Placentalia, placental mammals Urination, urinate and Ejaculation, ejaculate. The external urethral sphincter is a striated ...

) or an accessory skin tag to shut it off.

History

The principle of ligation is attributed to

Hippocrates Hippocrates of Kos (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...

and

Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...

. In

ancient Rome In modern historiography, ancient Rome is the Roman people, Roman civilisation from the founding of Rome, founding of the Italian city of Rome in the 8th century BC to the Fall of the Western Roman Empire, collapse of the Western Roman Em ...

, ligatures were used to treat

hemorrhoids Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''he ...

. Spanish Muslim doctor

Al-Zahrawi Abū al-Qāsim Khalaf ibn al-'Abbās al-Zahrāwī al-Ansari (;‎ c. 936–1013), popularly known as al-Zahrawi (), Latinisation of names, Latinised as Albucasis or Abulcasis (from Arabic ''Abū al-Qāsim''), was an Arabs, Arab physician, su ...

described the procedure around the year 1000 in his book ''

Kitab al-Tasrif The ''Kitāb al-Taṣrīf'' (), known in English as The Method of Medicine, is a 30-volume Arabic encyclopedia on medicine and surgery, written near the year 1000 by Abu al-Qasim al-Zahrawi (Abulcasis). It is available in translation. The took a ...

''. The concept of a ligature was reintroduced some 500 years later by

Ambroise Paré Ambroise Paré (; – 20 December 1590) was a French barber surgeon who served in that role for kings Henry II, Francis II, Charles IX and Henry III. He is considered one of the fathers of surgery and modern forensic pathology and a pione ...

and first performed by him in the village of

Damvillers Damvillers () is a commune in the Meuse department in Grand Est in north-eastern France. History Damvillers was part of the Duchy of Luxembourg, which was part of the Spanish Netherlands . In 1552, France intervened in the princes' revolt and ...

. It finally found its modern use in 1870–1880, made popular by

Jules-Émile Péan Jules-Émile Péan (; 29 November 1830 – 20 January 1898) was one of the great French surgeons of the 19th century. Péan was born in 1830 in Marboué, french department of Eure-et-Loir. He studied at the college of Chartres and then studied ...

Procedure

With a blood vessel the surgeon will clamp the vessel perpendicular to the axis of the artery or vein with a

hemostat A hemostat (also called a hemostatic clamp; arterial forceps; and pean, after Jules-Émile Péan) is a tool used to control bleeding during surgery. Similar in design to both pliers and scissors, it is used to clamp exposed blood vessels shut. ...

, then secure it by ligating it; i.e. using a piece of suture around it before dividing the structure and releasing the hemostat. It is different from a

tourniquet A tourniquet is a device that is used to apply pressure to a limb or extremity in order to create ischemia or stopping the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation. A simple tourniquet can ...

in that the tourniquet will not be secured by knots and it can therefore be released/tightened at will. Ligation is one of the remedies to treat

skin tag A skin tag, or acrochordon (: acrochorda), is a small benign tumor that forms primarily in areas where the Human skin, skin forms creases (or rubs together), such as the neck, armpit and groin. They may also occur on the face, usually on the ey ...

, or acrochorda. It is done by tying string or

dental floss Dental floss is a cord of thin filaments, typically made of nylon or silk, used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use a ...

around the acrochordon to cut off the blood circulation. Home remedies include commercial ligation bands that can be placed around the base of skin tags. Complications of ligation in

polydactyly Polydactyly is a birth defect that results in extra fingers or toes. The hands are more commonly involved than the feet. Extra fingers may be painful, affect self-esteem, or result in clumsiness. It is associated with at least 39 genetic mut ...

treatment include infection, neuroma or cyst formation.

References

Surgical procedures and techniques {{Treatment-stub kk:Лигатура

History

Procedure

See also

References