Cesarean section . nted distinctly in their neither type of operation is the peritoneal cavity absolutely safe fromcontamination, since it may be opened accidentally when either procedureis carried out with resulting infection, or in cases of virulent infectionof the uterus peritonitis and death may result from extension of theinfection through the intact peritoneum, although the operation may havebeen perfectly performed. Another advantage of the transperitoneal EXTRA- AND TRANSPERITONEAL CESAREAN SECTIONS 169 route is that drainage of the wound is unnecessary, whereas it is neces-sa
Cesarean section . nted distinctly in their neither type of operation is the peritoneal cavity absolutely safe fromcontamination, since it may be opened accidentally when either procedureis carried out with resulting infection, or in cases of virulent infectionof the uterus peritonitis and death may result from extension of theinfection through the intact peritoneum, although the operation may havebeen perfectly performed. Another advantage of the transperitoneal EXTRA- AND TRANSPERITONEAL CESAREAN SECTIONS 169 route is that drainage of the wound is unnecessary, whereas it is neces-sary in the extraperitoneal operation of the Kiistner type, and perhapsafter the Latzko operation, and drainage may result in infection of theconnective tissue of the prevesical space in patients who might other-wise escape infection and result in a prolonged suppurative process,which may result fatally. Furthermore, the extensive adhesions leftafter the Kiistner operation limit its application to a single operation,. Fig. 46.—Hirsts Operation (III).Incising visceral peritoneum over lower uterine segment. an objection which does not hold true, however, in the Latzko , if it is desired to render future pregnancies impossible, steriliza-tion can only be performed at a second operation. In the transperitoneal method the operation may be repeated in sub-sequent pregnancies if desired, and if it is thought best to sterilize thepatient without removing the uterus, this can be done before the visceralperitoneum is opened, which obviates a second operation for this pur-pose and adds nothing to the risk of the operation. This contingency ishardly liable to arise, however, if the operation is limited, as I believeit should be, to those cases which, though not frankly infected, are con- 170 CESAREAN SECTION sidered poor risks for a classical operation. In these cases the best pro-cedure, if sterilization is considered advisable, is supravaginal amputationof the uterus, si
Size: 1634px × 1529px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., book, bookcentury1900, bookdecade1920, booksubjectcesareansection
