. The diagnosis and treatment of diseases of women. wall. The giasping of the ligament of each side with thetenaculum-forceps facilitates the subsequent manipulation of the ligaments, afterthe removal of the retractors which expose the pelvic cavity. 2. The point of the puncturing tenaculum-forceps (Fig. 601) is entered in theleft side of the wound, just beneath the upper sheath of the rectus muscle andabout one inch above the pubic bone. It is passed outward just beneath thesheath for an inch and then the point is directed downward and made to punc-ture the rectus muscle and posterior sheath,
. The diagnosis and treatment of diseases of women. wall. The giasping of the ligament of each side with thetenaculum-forceps facilitates the subsequent manipulation of the ligaments, afterthe removal of the retractors which expose the pelvic cavity. 2. The point of the puncturing tenaculum-forceps (Fig. 601) is entered in theleft side of the wound, just beneath the upper sheath of the rectus muscle andabout one inch above the pubic bone. It is passed outward just beneath thesheath for an inch and then the point is directed downward and made to punc-ture the rectus muscle and posterior sheath, but not the peritoneimi. Guidedby the fingeiS in the ab-domen, it is then passedout waul between the pe-litoneum and the apo-neurosis to a point aboutone inch from the in-ternal inguinal ring,where it is made to pe-netrate the peritoneum. //f /W J 11 The handle of the in-strument is then raisedso as to direct the pointtoward the round liga-ment, and it is made tograsp the ligament andoverlying peritoneumabout 12^ inches from theuterus (Fig. 602).. Fig. 601. The Puuctuiing Tenacukun-Forceps. The instrument isstrongly made and slender, and is designed to pass easily tlirough thetissues of the abdominal wall, to penetrate the aponeurosis and peri-toneum at any desired point, to grasp the round ligament firmly with-out bruising it, and to return through the wall, bringing the ligamentalong the new canal. (Crossen—Journal of American Medical Associa-tion.) 616 DISPLACEMENTS OF THE UTERUS ? In the class of cases under consideration, the hgament and peritoneum areusually so stretched and lax that they are easily drawn into the new canal as asmall cord. If the ligament is unusually thick oi if the peritoneum is so thickenedthat it probably will not pass easily into the forceps canal, a window may besnipped in the peritoneum in front of the ligament and the ligament alone graspedand brought into the canal. 3. The forceps is then withdrawn, bringing the ligament with it into the force
Size: 2072px × 1207px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubje, booksubjectgynecology
