. Minor surgery and bandaging; including the treatment of fractures and dislocations, the ligation of arteries, amputations, excisions and resections, intestinal anastomosis, operations upon nerves and tendons, tracheotomy, intubation of the larynx, rosis ofthe external oblique muscle, and then divide the fibresof the internal oblique and transversalis muscles upon adirector and expose the transversalis fascia. This isopened at the lower part of the wound, and the fingeris introduced and the peritoneum pressed back; theopening in the transversalis fascia is next enlarged, andthe peritone
. Minor surgery and bandaging; including the treatment of fractures and dislocations, the ligation of arteries, amputations, excisions and resections, intestinal anastomosis, operations upon nerves and tendons, tracheotomy, intubation of the larynx, rosis ofthe external oblique muscle, and then divide the fibresof the internal oblique and transversalis muscles upon adirector and expose the transversalis fascia. This isopened at the lower part of the wound, and the fingeris introduced and the peritoneum pressed back; theopening in the transversalis fascia is next enlarged, andthe peritoneum is carefully drawn inward and upwardwith the fingers toward the inner edge of the operator next feels for the external iliac artery, andpasses the finger along this until the common iliac artery LIGATION OF THE INTERNAL ILIAC ARTERY. 465 is reached. The loose cellular tissue in which it is im-bedded is next separated, and the needle is passed fromwithin outward, to avoid the common iliac vein (), which on the left side lies on the inner side of theartery, and on the right side lies behind the artery. Theureter generally remains attached to the peritoneum ; ifnot, it is seen crossing the bifurcation of the common iliac Fig. Ligation of the common iliac artery. (Liston.) with the genito-crural nerve ; care should be taken toavoid injury of these structures. Transperitoneal Method.—The common iliac artery mayalso be exposed and tied by an incision made over theartery through the abdominal wall opening the peritonealcavity: the vessel being tied, the ends of the ligature arecut short, and the external wound is closed in the samemanner as that resulting from exposure of the abdom-inal aorta by incision through the peritoneum. Ligation of the Internal Iliac Artery.—The incisionis in the same line as for the common iliac artery, but it 30 466 OPERATIONS. need not be quite so long (Fig. 355, A). The peritoneumbeing exposed, it is pushed upward and inward,
Size: 1404px × 1781px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1902
