Gynecology . antation, most commonly between the leaves of the broad ligament and inthe abdominal wall. Of these two sites, the latter is far preferable, partly becausethe blood-supply is more favorable for the graft and partly because it is moreaccessible if by chance the tissue later becomes cystic or gives trouble the abdominal wall has been chosen as the site of implantation the opera-tion is completed as far as the closure of the abdominal fascia. A place is thenchosen where the sheath surrounds the edge of one of the recti muscles. A smallslit is made in the sheath at the mu
Gynecology . antation, most commonly between the leaves of the broad ligament and inthe abdominal wall. Of these two sites, the latter is far preferable, partly becausethe blood-supply is more favorable for the graft and partly because it is moreaccessible if by chance the tissue later becomes cystic or gives trouble the abdominal wall has been chosen as the site of implantation the opera-tion is completed as far as the closure of the abdominal fascia. A place is thenchosen where the sheath surrounds the edge of one of the recti muscles. A smallslit is made in the sheath at the muscle border. The ovary is taken from thesalt solution and a slice removed from the healthiest part, including, if possible, OPERATIONS ON THE OVARIES 665 epithelium, cortex, and medullary tissue. The piece of ovary is now slippedinto the small opening in the muscle sheath (Fig. 370), and placed so that it liesbetween muscle and fascia. The opening in the fascia is closed with one sutureof fine catgut. Ouancvn. Fig. 370.—Implantation of Ovarian Tissue in Abdominal slice from the ovary is being inserted between the fascia and right rectus muscle. It is important to remember that the whole organ should not be implantedin the abdominal wall, for it is almost sure to give later trouble by cystic degenera-tion. By using a slice of the ovary the establishment of a new circulation in thegraft is more surely accomplished than if the intact ovary is implanted. OPERATIONS ON THE ABDOMINAL WALL BARDENHEUERS INCISION An extended transverse incision for difficult pelvic operations is used fre-quently abroad, but very little in this country. This incision is carried witha moderate downward curve from one anterior superior spine to the incision is made transversely through the entire wall, including skin, fascia,muscle, and peritoneum. As a rule, only the recti are divided, but if the opera-tion demands it the lateral muscles of the abdomen may also be cut.
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