Operative surgery . Fig. 1091.—Instruments employed in paracentesis abdominis, thoracentesis, tapping ])ericardium, Emmets trocai. &. Rectal trocar, c. Duncans trocar, d. Nest of trocars, assortedsizes, e. Common trocar. /. Fitchs aspirating protected pointed trocars, assortedsizes, g. Billroths aspirating trocar. //. Aspirating syringes. Other forms of aspi-rators may be employed. Figs. 1093 and 1246. The Operation.—Carefully localize the proper scat of puncture by per-cussion, and estimate the thickness of the abdominal Avail; adjust the slit inthe bandage to correspond to the point o
Operative surgery . Fig. 1091.—Instruments employed in paracentesis abdominis, thoracentesis, tapping ])ericardium, Emmets trocai. &. Rectal trocar, c. Duncans trocar, d. Nest of trocars, assortedsizes, e. Common trocar. /. Fitchs aspirating protected pointed trocars, assortedsizes, g. Billroths aspirating trocar. //. Aspirating syringes. Other forms of aspi-rators may be employed. Figs. 1093 and 1246. The Operation.—Carefully localize the proper scat of puncture by per-cussion, and estimate the thickness of the abdominal Avail; adjust the slit inthe bandage to correspond to the point of introduction; seize the instrumentfirmly with the index finger so placed on the upper surface as to limit theextent of the introduction (Fig. 1092); push the instrument quickly intothe abdomen and withdraw the trocar,leaving the cannula in place; tightenthe bandage as the fluid escapes, to facilitate the flow and support the ()1M:K.\11(>NS ox NISCMKA CONMOCil:!) WITH S!»7. Fi(i. 1092.—Tlie operation of abdominiswith trocar. paliiMil ; Iciiinvc llic caiiiiiihi as suuii as the lluid has cscapcil, and whensyncojic is iinjiciulini;- and further withdrawal at this time is iinpiucticable ;\ close the j)unetiirc with iin iii- terniptod deep sutuie of cat-gut, and dress tin; ])ai-t withgauze held in place with abandage. Tlie Precautions. — Care-fully avoid puncture of a dis-tended bladder or nterus andof a displaced or enlarged vis-cus. If the ])nncture be madetoo near the line of dtdlness,or the instrument be misdi-rected, the intestines may bewounded. Carefully avoidpnnctnre of the abdominalwall at the established site of significant blood-vessels. The plngging ofthe needle or cannula by fibrin is relieved by the introduction of a probe,causing dislodgment of the ob-struction. As the fluid escapes,the intra-abdominal end of theinstrument should be so changedin its direction from time totime as to avoid impingementon the intestines, especiall
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
