. Operative gynecology. lar adhesions under other circumstances, as described in Chapter XX COMPLICATIONS OF HYSTERO-JIYOJIECTOJIY. 3T5 on General Principles. It is only necessary to speak here first of the frequencywith which myomata are complicated by pelvic peritonitis, and, second, of thedifficulties of releasing-inflamed ovaries and tubes, from the fact that they areoften so completely buried behind the tumors, or wedged down into the pelvis,that they are hard to reach without injuring some of the great vascular sinusesin their immediate neighborhood. When they can be got at without speci
. Operative gynecology. lar adhesions under other circumstances, as described in Chapter XX COMPLICATIONS OF HYSTERO-JIYOJIECTOJIY. 3T5 on General Principles. It is only necessary to speak here first of the frequencywith which myomata are complicated by pelvic peritonitis, and, second, of thedifficulties of releasing-inflamed ovaries and tubes, from the fact that they areoften so completely buried behind the tumors, or wedged down into the pelvis,that they are hard to reach without injuring some of the great vascular sinusesin their immediate neighborhood. When they can be got at without specialdifficulty, an adherent tube and ovary, or a hydrosalpinx, or even a pyosalpinx,may be gently released by gradually working the fingers down between the in-flamed structures and the posterior pelvic wall until their under surface isreached, when they are carefully freed from their adhesions to the pelvic floorand walls, and as they are brought up and out of the pelvis, detached also fromtheir broad-ligament Fig. 500.—Complicated uterus witli on the riglit side, and a large ovarian cyst on tlie left side. Ilystoro-myoinectoniy. Eecovery. Path. No. }^ natural size. It frequently happens on the left side that these inflamed structures are cov-ered in by an adherent sigmoid flexure, and in order to reach them this must bedissected off by pulling it away from the tumor, so as to expose the cellularinterval which is cut with scissors. When the inflamed tube andovary are hard to reach, either because they are shelteredby the tumor or because they are wedged down in thepelvis, or when the adhesions are so dense that it is dan-gerous to break them up by touch without the controllingaid of sight, it is best to begin the enucleation by seekingout the ovarian vessels at the outer extremity of the broadligament and tying them at two points and cutting them between, andthen tying off the round ligament in the same way. By this
Size: 2866px × 872px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
