1. Two Hand Tie - Step 1 … and the thumb of the left hand is beginning to create a loop by pushing the long strand to the right. Note that the short end is in the right hand...

2. Two Hand Tie - Step2 Note that the left thumb protrudes through the loop and the left forefinger contacts the thumb, so the thumb can guide it down through the loop. The right hand has brought the short end toward the surgeon and across the left hand strand to form a loop.

3. Two Hand Tie - Step3 The left forefinger has been rotated down into the loop.

4. Two Hand Tie - Step 4 The short strand is now placed between the thumb and forefinger in order to transport the short end up through the loop.

5. Two Hand Tie - Step 5 The hand is now rotated to bring the thumb back up through the loop, pushing the short end up with it.

6. Two Hand Tie - Step 6 The short end has now emerged completely through the loop and is being re-grasped with the right hand in order to tighten the "throw" that has been created.

7. Two Hand Tie - Step 7... and pulling the short end toward himself. The surgeon begins to tighten the throw by pushing the long strand away...

8. Two Hand Tie - Step 8 The throw is tightened.

9. Two Hand Tie - Step 9 Note that tension is applied by pulling the two strands in opposite directions at an angle of 180 o. The throw is now snugged down.

10. Two Hand Tie - Step 10 The left forefinger now begins to form the loop for the next throw by sliding beneath the long strand and pushing it to the right.

11. Two Hand Tie - Step 11 The short strand is now brought to the left and beneath the long strand to form the new loop.

12. Two Hand Tie - Step 12 The left thumb contacts the forefinger and begins to rotate up into the loop.

13. Two Hand Tie - Step 13 The left thumb has now emerged from the loop, and the short strand will be pinched between the thumb and forefinger of the left hand.

14. Two Hand Tie - Step 14... and the left hand is now rotated in the opposite direction to drive the short end through the loop toward the surgeon. The right hand releases the short end…

15. Two Hand Tie - Step 15 The short end is re-grasped by the right hand and pulled away from the surgeon.

16. Two Hand Tie - Step 16 The second throw is now snugged down by pulling the strands in opposite directions at an angle of 180 o.

17. Two Hand Tie - Step 17 The 3rd throw is now begun as the left thumb pushes the long strand to the right in the same way the 1st throw was begun.

18. Two Hand Tie - Step 18 1) The short strand has been pulled toward the surgeon and... 2) the left index finger has been rotated clockwise into the loop. The short strand will be grasped between the thumb and index finger. 1 2

19. Two Hand Tie - Step 19 After grasping the short end, the left thumb is rotated back up through the loop in a counterclockwise direction.

20. Two Hand Tie - Step 20 The short end is pulled toward the surgeon, and the long end is pulled away.

21. Two Hand - 1st Throw (animated)

22. Two Hand Tie - 2nd Throw (Animated)

23. Two Hand Tie - Both Throws (Animated)