The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ity at the circumference of the ex-posed area of the fundus of the gall-bladder. If the opera-tion is to be conducted in two sittings the assistant nowhands a loose gauze pad for covering the wound, and theusual outer dressings. If the operation is to be concludedat once, however, the assistant will act next according as towhether the gall-bladder contains chiefly stones and verylittle fluid or is distended with fluid (hydrops, empyema). »03 Cholecystostomy, 203 In the first case he will hand scalpel a
The surgical assistant, a manual for students, practitioners, hospital internes and nurses . ity at the circumference of the ex-posed area of the fundus of the gall-bladder. If the opera-tion is to be conducted in two sittings the assistant nowhands a loose gauze pad for covering the wound, and theusual outer dressings. If the operation is to be concludedat once, however, the assistant will act next according as towhether the gall-bladder contains chiefly stones and verylittle fluid or is distended with fluid (hydrops, empyema). »03 Cholecystostomy, 203 In the first case he will hand scalpel and mouse-tooth forcepsfor opening the viscus, forceps and spoons for removingstones, sound for probing the ducts, tube for drainage, [cat-gut gall-bladder suture], and dressing. In the second casean aspirating syringe having first been handed for determin-ing the contents of the bladder, the assistant turns the pa-tient so that he lies on his right side near the edge of thetable, covering meanwhile with a sponge or pledget of gauzethe needle hole in the bladder. A bib of sterilized rub-. FiG. 75. Assistant holding patient on his side while contents of gall-bladderflow into pus basin. ber tissue is then placed over the lower portion of thewound and tucked into its angles, to prevent soiling of thetissues. A pus basin being held in position, scalpel anddressing forceps are passed to open the or two drainage tubes will next be needed throughwhich to irrigate the viscus, and after these stone forcepsand sounds. S04 The Surgical Assistant. When cholecystotomy is performed sutures of catgut, toclose the mucous membrane, and of silk for the peritonealcovering of the gall-bladder, are to be ready. Choledochotomy. Retractors, wide and narrow gauzepackings, and ligatures for adhesions will be needed muchas for cholecystostomy. If the common duct is being at-tacked there should be handed two guy sutures to secure iton each side of the proposed line of incision; then scal
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1905
