A manual of operative surgery . mur, and is reached between the semi - membranosusmuscle and the tendon of theadductor magnus. Operation.—-The patient liesupon the back, with the hip alittle flexed and the thigh fullyabducted and rotated knee-joint is bent at a rightangle, and the knee and leg arethus made to lie upon the outer surgeon stands to the outerside of the extremity in either incision on the right side ismade from above downwards, andon the left from below chief assistant faces theoperator. The incision is three inches inlength, is commenced
A manual of operative surgery . mur, and is reached between the semi - membranosusmuscle and the tendon of theadductor magnus. Operation.—-The patient liesupon the back, with the hip alittle flexed and the thigh fullyabducted and rotated knee-joint is bent at a rightangle, and the knee and leg arethus made to lie upon the outer surgeon stands to the outerside of the extremity in either incision on the right side ismade from above downwards, andon the left from below chief assistant faces theoperator. The incision is three inches inlength, is commenced at the junction of the middle and thelower thirds of the thigh, and is parallel with and just posteriorto the tendon of the adductor magnus. The position of thistendon should have been well defined (Fig. 339). After the skin has been divided there will probably be foundin the subcutaneous fat the anterior division of the internalcutaneous nerve, which lies usually in the direct line of theoperation. It should be drawn FIG. 338.—LIGATURE OF RIGHT POP-LITEAL ARTERY (LOWER PART). A, Fascia ; B, Gastrocnemius ; a, Pop-liteal artery ; b, Popliteal vein ; c,External saphenous vein ; i, Internalpopliteal nerve; 2, Muscular branches ;3, External saphenous nerve. chap, iv] LIGATURE OF THE POPLITEAL 409 The anterior edge of the sartorius muscle is next exposed,and the whole muscle must be displaced backwards. Upon this muscle at this point will lie the internal saphenousvein. The vessel may possibly be exposed, in which case it isdrawn backwards with the sartorius. The trunk of the internal saphenous nerve is not lies beneath the sartorius. The deep fascia having been well divided, the tendon of theadductor magnus is sought for, and is drawn forwards with ablunt hook. The semi-membranosus muscle is next exposed,and is drawn backwards with a retractor. The operator nowseeks for the artery in the interval between the two vessel will be surrounded
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