Treatise on gynæcology : medical and surgical . elimination of the ligature (Hegar)or fatal peritonitis (Olshausen, Czerny, Hegar). At other times theligature has been expelled without inconvenience to the patient. Ahl-feld32 cites an instance which the surgeon complicated by fasteningthe ligature, after having taken two turns about the pedicle, with aring of lead 5 mm. in diameter, which he crushed about the rubberwith strong forceps. This mode of fixing the ligature had alreadybeen employed by Thiersch,33 but only for extra-peritoneal treatment,and was then adopted by Sanger,34 who later aba
Treatise on gynæcology : medical and surgical . elimination of the ligature (Hegar)or fatal peritonitis (Olshausen, Czerny, Hegar). At other times theligature has been expelled without inconvenience to the patient. Ahl-feld32 cites an instance which the surgeon complicated by fasteningthe ligature, after having taken two turns about the pedicle, with aring of lead 5 mm. in diameter, which he crushed about the rubberwith strong forceps. This mode of fixing the ligature had alreadybeen employed by Thiersch,33 but only for extra-peritoneal treatment,and was then adopted by Sanger,34 who later abandoned it for hismixed method after obtaining nine successes without a single failure. TEEATME1STT OF FIBROUS TUMORS OF ABDOMINAL EVOLUTION. 293 The following procedures are cited only because of their originality:Schwarz35 has proposed to cover the elastic ligature with a fold of peritoneum cut from the pedicle. Meinert36 has proposed to open Douglas pouch and pass the pedicle into the vagina; he made the experiment once but the patient Fig. 155.—Ligature of the Pedicle! by Zweifels Method. A, Transfixion of pedicle with needlearmed first with threads la and lb; B, first thread withdrawn and second Ha and lib passed through eyeof needle, which is then withdrawn; C, needle re-introduced with thread Ila and lib a fingers breadthfrom the first puncture; this is repeated with the third thread and so on; D, pedicle traversed by a seriesof loops disposed for partial juxtaposed ligature. 294 CLINICAL AND OPERATIVE GYNECOLOGY. Hysterectomy lias been performed in two stages; the first con-sisting in opening the peritoneum and the production of adhesions;the second, of the removal of the tumor. Nussbaum37 has employedthis dangerous method in the case of a suppurating myoma; thepatient died. Vulliet38 has recently adopted it, but his patient, whenhe published his case, had not recovered. 1 Continuous Fractional Ligature (Fortlaufende Partienligatur).—Under this name Zweifel h
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