. Operative gynecology. of the superior strait, setting it free. Care must be taken not to make such traction on a pedunculate tumor as willresult in tearing its pedicle and causing a hemorrhage which might provetroublesome. A large tumor, the size of a childs head, may sometimes be deliv-ered with advantage with obstetrical forceps. Ligation of the Ovarian Vessels and Round Ligamentof One Side.—A fine silk ligature (No. 2) may be used to ligate the ovarianvessels, however large. The outer pelvic extremity of the broad ligament, oftenswollen by a congeries of large purple veins which cross the
. Operative gynecology. of the superior strait, setting it free. Care must be taken not to make such traction on a pedunculate tumor as willresult in tearing its pedicle and causing a hemorrhage which might provetroublesome. A large tumor, the size of a childs head, may sometimes be deliv-ered with advantage with obstetrical forceps. Ligation of the Ovarian Vessels and Round Ligamentof One Side.—A fine silk ligature (No. 2) may be used to ligate the ovarianvessels, however large. The outer pelvic extremity of the broad ligament, oftenswollen by a congeries of large purple veins which cross the pelvic brim underthe caput coli on the right side and under the sigmoid flexure on the left, isnow gathered up between the thumb and foretinger, and the clear space below thevessels sought for, through which a ligature is passed and tied tightly controllingthe vessels. It is always surprising to see a bunch of vessels as large as three orfour flnsrers contract down to a mere strand in the bite of a ligature. A second. J?iQ. 497.—Schematic the line of incision, beginning with the leftovarian vessel.* and ending with the right, in the extirpa-tion of the myomatous uterus. 3Y0 MYOMECTOMY—HYSTEKO-MYOMECTOMY. ligature or a clamp is applied 4 or 5 centimeters away, toward the uterus, andthe vessels cut between the two, at a good distance from the first ligature. In a woman under forty years of age it is better to leave both ovaries in thepelvis, with or without the uterine tubes; by doing this, although menstruationceases, the disagreeable symptoms of the artificially induced menopause areavoided. In this case the first and the last ligatures are applied near the hornof the uterus. The round ligament, often enlarged and vascular, is now lifted upnear the uterus and tied with catgut and cut through, and the uterine endclamped. The top of the broad ligament is opened up by these iacisions. Detaching the Vesico-uterine Peritoneum.—The uterus isnow drawn back and
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
