A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ter making the first incision with the scalpel, whichmay penetrate somewhat into the adipose tissue (if there isany), we pass the grooved director under successive layersof fascia and muscular tissue, and incise with the edge of thescalpel, away from the patient, till the peritonaeum is reached,when it should be seized with the hook forceps and an incis-ion made in it with a sharp pointed, straight scissors afterthe arrest of any hemorrhage. Into this cut made with thescissors I prefer to insert the
A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ter making the first incision with the scalpel, whichmay penetrate somewhat into the adipose tissue (if there isany), we pass the grooved director under successive layersof fascia and muscular tissue, and incise with the edge of thescalpel, away from the patient, till the peritonaeum is reached,when it should be seized with the hook forceps and an incis-ion made in it with a sharp pointed, straight scissors afterthe arrest of any hemorrhage. Into this cut made with thescissors I prefer to insert the index finger of the left hand,and explore for adhesions in the line I desire to incise theperitonaeum; and if I find adhesions make the incision to oneside of them, if possible, using the finger so inserted as adirector, making the incision (hrough the peritdnaeum inlength to correspond to the external cut. We now bring thetumor into view by separating the lips of the incision. The next step is to explore for adhesions, and make outa clearer diagnosis of the tumor; then tap the cyst (if it. Fig. No. 24.—Spencer Wells Artery Forceps. be one) with Spencer Wells trocar; detach adhesions;ligate the pedicle; remove the tumor; arrest the hemorrhage, OVARIOTOMY. 323 by torsion or ligation of the bleeding vessels; examine theother ovary, and remove it if required; cleanse the periton-eal cavity; close the incision; apply proper dressing; see thepatient placed properly in bed, and returned to conscious-ness. It is sometimes best to tap the cyst, or cysts, if therebe more than one of any size, before exploring much for adhe-sions, as it often is of so large a size as to be very difficultof examination before tapping. Before inserting the trocar place a small elastic band overthe instrument, and have it strong enough to clasp it firmly;then sieze the sac with a pair of hook forceps, draw it out
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Keywords: ., bookcentury1800, bookdecade1880, bookpublishere, booksubjectwomen
