How to tie a Miller's knot for uterine body ligation in pediatric ovariohysterectomy

Pass the suture under the tissue to be ligated.

Then pass it under the tissue again, creating a loop.

Pass the needle holder through the loop.

Wrap the long strand of suture once around the needle holder.

Grasp the short strand of suture with the needle holder, pulling the short strand toward you and the long strand of suture away from you.

Throw three to four more square knot throws on top of the Miller's throw, resulting in a secure knot.