. Pelvic inflammation in women. assed under the Vesical Reflection of thePeritoneum which is Cut Free of the Uterus. , jM^«\ Forceps holding flapHf\\\ of bladder rerlection Suture on ; ^fl liyi^ _,^gs5 K^|t%^ ^00^ ^^x^^ li^^^l m^ ( ^A -v^bgjiFtero-vgsicat M^Mt y^ Mk ^^^^^k W [ f\ imMm^Uj^^ ^ 1^1 ^^^r ti^^^tm ^iHJlAo^^^^^^le^^HV^ v^HI^M^/ iP^i^^L^ l^^^^r^^l K/ ^l^\ ^■^l j^H^lH Hi i^?^^! ^m^\ ^^^^^^mtfi ^ ■ ^^^|H|rjHtt^\ ^^B ^ITj.^K^^^^BjI^yy ] ^^KAl^^^k^^B Fig. 73.— Anterior Bladder Reflection Carried Over Vaginal Vault, 174 SALPINGITIS 175 The abdomen is opened by a long incision in the
. Pelvic inflammation in women. assed under the Vesical Reflection of thePeritoneum which is Cut Free of the Uterus. , jM^«\ Forceps holding flapHf\\\ of bladder rerlection Suture on ; ^fl liyi^ _,^gs5 K^|t%^ ^00^ ^^x^^ li^^^l m^ ( ^A -v^bgjiFtero-vgsicat M^Mt y^ Mk ^^^^^k W [ f\ imMm^Uj^^ ^ 1^1 ^^^r ti^^^tm ^iHJlAo^^^^^^le^^HV^ v^HI^M^/ iP^i^^L^ l^^^^r^^l K/ ^l^\ ^■^l j^H^lH Hi i^?^^! ^m^\ ^^^^^^mtfi ^ ■ ^^^|H|rjHtt^\ ^^B ^ITj.^K^^^^BjI^yy ] ^^KAl^^^k^^B Fig. 73.— Anterior Bladder Reflection Carried Over Vaginal Vault, 174 SALPINGITIS 175 The abdomen is opened by a long incision in the median line, orjust to the right of the median Hne. The incision should extend from thepubis to above the umbilicus, for a long incision greatly facilitates theease of operation. As soon as the peritoneum is opened, two fingers areinserted in the lower end of the abdominal incision, elevating it. Thisallows air to enter the peritoneal cavity, and the atmospheric pressure Scissors spreading Ketraclcr holdincr. Ovarian arteryligaied HJ-SKannorv Fig. 74.— The Bladder is Retracted axd Uterine Artery Exposed. causes the intestines to further recede from the field of operation. Thewound edges are now protected by towels, and a moist laparotomy spongeis placed across the pelvic brim, so as to protect the intestines fromtrauma and infection. The uterine fundus is grasped by a large Jacobs forceps and theuterus is drawn up out of the wound and the adhesions of the tubes andovaries freed, so that the infundibulopelvic ligaments with their con-tained blood vessels are exposed. A Kocher clamp is now placed on theinfundibulopelvic ligament (Fig. 70), including the ovarian artery and 176 PELVIC INFLAMMATION IN WOMEN vein. Distal to this clamp, a. suture ligature is passed through the freespace in the ligament, and the ovarian artery and vein tied. The liga-ment is now cut distal to the clamp and the vessels retract. The roundligament is next grasped with a clamp and tie
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Keywords: ., bookcentury1900, bookdecade1920, bookpublishernewyo, bookyear1921
