Operative surgery, for students and practitioners . refully examined. For the purpose of palpation of thecommon duct, etc., two fingers of the left hand are introduced intothe foramen of Winslow, behind the free edge of the lesser omentum,and, with the thumb opposed anteriorly, the entire length of the com-mon and hepatic ducts can be satisfactorily examined. In some excep-tional cases it may be necessary to enlarge the abdominal incision inorder to get better access to the bile-ducts. After the examination of the bile-ducts has been completed thegall-bladder is brought up into the incision an
Operative surgery, for students and practitioners . refully examined. For the purpose of palpation of thecommon duct, etc., two fingers of the left hand are introduced intothe foramen of Winslow, behind the free edge of the lesser omentum,and, with the thumb opposed anteriorly, the entire length of the com-mon and hepatic ducts can be satisfactorily examined. In some excep-tional cases it may be necessary to enlarge the abdominal incision inorder to get better access to the bile-ducts. After the examination of the bile-ducts has been completed thegall-bladder is brought up into the incision and secured by catchingits fundus with two sharp-nosed artery clamps, one on each trochar is thrust into the gall-bladder between the two clampsand the bladder emptied as nearly completely as possible. If a pieceof rubber tubing is attached to the end of the trochar the contents ofthe gall-bladder may be conducted over the side of the table andthus avoid soiling the field of operation. When the bladder collapsesstones may be felt within Fig. 233. -Cholecystostomy. Purse-string to close incision in fundus of gall-bladder around the drainage tube has been introduced.
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