A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . y must be remembered that septic infection is the sole risk thewoman runs in the hands of an operator familiar with thetechnique. ECTOPIC GESTATION. 197 The operation is likely to prove of shorter duration if thewoman be placed in the Trendelenburg position. This positionmay be improvised by tying an ordinary kitchen-chair to thetable so as to form the inclined plane. (See next page.) In addition to the instruments, the operator should haveprepared at least four large, f
A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . y must be remembered that septic infection is the sole risk thewoman runs in the hands of an operator familiar with thetechnique. ECTOPIC GESTATION. 197 The operation is likely to prove of shorter duration if thewoman be placed in the Trendelenburg position. This positionmay be improvised by tying an ordinary kitchen-chair to thetable so as to form the inclined plane. (See next page.) In addition to the instruments, the operator should haveprepared at least four large, flat, gauze pads and one dozensmall gauze sponges. A quart-bottle full of 1-per-cent. hot(120° F.) sterilized salt-solution should be ready to irrigate theperitoneal cavity, in the event of threatened collapse from un-avoidable • haemorrhage. The peritoneum rapidly absorbs thesalt-solution, and it forms our readiest restorative. The usual incision is made down to the peritoneum, aboutthree inches in length, extending upward from above the haemorrhage is checked by torsion of the small vessels. !. Fig. 83.—Clevelands Ligature-Carrier. Before opening the peritoneum the operator should emphasizehis injunction that absolutely no antiseptics are to be used inthe further progress of the operation. The peritoneal cavity having been entered, one or more ofthe large gauze pads, wrung dry from the sterilized water, areinserted to keep the intestines from the abdominal one or two fingers the operator liberates the tube andovary (if adherent) and brings them out of the abdominalincision. The ovarian artery being very vascular, it is desir-able, when feasible, to isolate it and tie it separately withmedium-sized sterilized silk. The pedicle is transfixed by theligature-carrier; a stout, sterilized, Chinese-silk ligature isbrought through, the ends are crossed and firmly tied, afterthe usual manner. The appendages are then removed. 198 OBSTETRIC SURGERY. The tube a
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