. Modern surgery, general and operative. uccessfully by Dr. \Vm. Gibson in iSi2. Itwas first successfully ligated by Valentine Mott in 1827. The patient is placedrecumbent or in the Trendelenburg position. The body is then turned a Httleto the opposite side and the thighs are partly flexed. Bryant says there are ;6o Diseases and Injuries of the Heart and Vessels two linear guides for this artery. Cramptons line is drawn from the apex ofthe cartilage of the last rib downward and a little forward nearly to the crestof the ilium, then carried forward parallel with it to a little below the ante-ri
. Modern surgery, general and operative. uccessfully by Dr. \Vm. Gibson in iSi2. Itwas first successfully ligated by Valentine Mott in 1827. The patient is placedrecumbent or in the Trendelenburg position. The body is then turned a Httleto the opposite side and the thighs are partly flexed. Bryant says there are ;6o Diseases and Injuries of the Heart and Vessels two linear guides for this artery. Cramptons line is drawn from the apex ofthe cartilage of the last rib downward and a little forward nearly to the crestof the ilium, then carried forward parallel with it to a little below the ante-rior-superior spine (Operative Surgery, by Joseph D. Bryant). McKeesline is drawn from the tip of the cartilage of the eleventh rib to a point i^^inches within the anterior-superior spine, then curved downward, forward,and inward, and terminating abruptlv above the internal abdominal ring(Ibid.). The incision can be begun just external to the internal abdominal ringand be curved upward and outward as in ligation of the external iliac, but. Fig. 285.—.4, Nephrotomy: a, last dorsal n.; b, latissimus dorsal m.; c, serratus post, in-ferior m.; d, middle layer of lumbar fascia; e, outer layer;/, ext. oblique m.; g, int. oblique m.;h, perinephritic (extraperitoneal) fat; /, quadratus lumborum m.; j. erector spinas m. B,Nephrotomy: a. first lumbar n.; b, kidney; c. transversalis fascia. C, Ligature of the sciaticand internal pudic arteries, and exposure of the great sciatic, small sciatic, and internal pudicnerves; a, gluteus maximus m.; b, inf. gluteal n.; c, sciatic a.; d, int. pudic a. and n.; e, greatsciatic n.; /, small sciatic n.; g, pyriformis m. D, Ligature of the gluteal artery and exposure ofthe superior gluteal nerve: a, gluteus maximus m.; 6, gluteal a.; c, superior gluteal n.; d,pyriformis m.; e, gluteus medius m. (Kocher). Cramptons incision gives more room. The superficial tissues are divideddown to the transversalis fascia, this structure is nicked and divided, and the
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