An American text-book of genito-urinary diseases, syphilis and diseases of the skin . er tense. In this way the ureter is freed and followed to the broad liga-ment, where considerable resistance may be felt, and the ureter appears to passthrough an opening in the ligament, above which the pulsations of the uterineartery can be felt. At this point, about 6 cm. from the kidney, the abdominalend of the ureter is caught in forceps and held, and a stout silk ligature putaround it and tied securely just behind the broad ligament. By pushing andworking with the finger about 2 cm. more of the ureter i
An American text-book of genito-urinary diseases, syphilis and diseases of the skin . er tense. In this way the ureter is freed and followed to the broad liga-ment, where considerable resistance may be felt, and the ureter appears to passthrough an opening in the ligament, above which the pulsations of the uterineartery can be felt. At this point, about 6 cm. from the kidney, the abdominalend of the ureter is caught in forceps and held, and a stout silk ligature putaround it and tied securely just behind the broad ligament. By pushing andworking with the finger about 2 cm. more of the ureter is freed. The ureteris now cut off \ cm. above the ligature with a long pair of scissors introducedthrough the lumbar incision, guided by the hand introduced into the pelvisin the same way. Before cutting through the ureter the operator should takecare to squeeze back its contents and keep the upper end tightly compresseduntil it is removed. The next step is the removal of the lower end of the ureter. This isdone either through a continuation of the original incision or through the. Fig. 187.—Renal vessels divided and meter freed down to the brim of the pelvis. The object of thispicture is to show the ease with which the entire abdominal portion of the ureter can be palpatedthrough a horizontal incision, with only a part of the hand introduced (Kelly). vagina. The vagina is thoroughly disinfected, and with the patient lyingon the opposite side, two fingers of the hand corresponding to the ureter tobe removed are passed up to the vaginal vault, and the other hand introducedinto the pelvis through the abdominal incision. The fingers of both handscan now be brought together with only vaginal tissue between them. Anopening is made in the vaginal vault, the end of the ureter brought downinto the vagina, clamped in a pair of forceps until the lumbar wound isclosed, after which the vaginal end of the ureter is removed. The steps in this operation are as follows: The opening in the va
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Keywords: ., bookcentury1800, bookdecade1890, booksubject, booksubjectsyphilis
