. A manual of gynæcology and pelvic surgery, for students and practitioners. stbehind the inner. Each clamp should be loosened as the firstknot is drawn down, and the clamp be entirely removed as soonas it is found that the knot is tight and the thread not likelyto break. A neater method of operating should be used whentime is of no special moment. This consists of clamping theovarian vessels at the outer end of the broad ligament externalto the ovary, excising the uterine end of the tube from the SALPINGECTOMY 373 uterine wall, clamping the utero-ovarian artery just beneath thispoint, cutting
. A manual of gynæcology and pelvic surgery, for students and practitioners. stbehind the inner. Each clamp should be loosened as the firstknot is drawn down, and the clamp be entirely removed as soonas it is found that the knot is tight and the thread not likelyto break. A neater method of operating should be used whentime is of no special moment. This consists of clamping theovarian vessels at the outer end of the broad ligament externalto the ovary, excising the uterine end of the tube from the SALPINGECTOMY 373 uterine wall, clamping the utero-ovarian artery just beneath thispoint, cutting away the tubo-ovarian mass, and clamping anysmall vessels that spurt in the mid-portion of the broad operation is completed by tying all vessels and whippingover the top of the broad ligament with a continuous catgutstitch. In this manner but little raw surface is left to contractadhesions to the intestine or omentum, and the tube is so re-moved that no stump remains to give further trouble. If theovary is to be retained, the clamp or ligature applied to the. Fig. 198.—Salpingectomy. Anterior view. The operation is completed bytying all vessels and whipping over the top of the broad ligament. outer end of the broad ligament should be placed between theovary and tube. Ligation of the ovarian artery external to theovary produces so much disturbance of its nutrition that moreor less subsequent pain and degeneration of the ovary withcyst formation is to be anticipated. As the stump is short, theligature between the tube and ovary, whether placed before orafter clamping, must be very carefully applied and it is a wisesafeguard to whip this over with a fine catgut stitch after theligature is tied. Both tubes having been removed, it may befound that injured veins are bleeding upon the posterior surface 374 DISEASES OF THE UTERINE TUBES of the broad ligaments. These should be caught separatelyand either tied with plain catgut or closed with sutures of thesame material,
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