Preparatory and after treatment in operative cases . us which achieves the objectand mav be raised or lowered as desired. Fig. 87 shows this CHOLECYSTOTOMY 513 apparatus affixed to the operating table. By this means the liveris made to be present in the wound, and access to the cystic andcommon duct is made comparatively easy. In addition to this,the head of the table may be elevated to the extent of 35°, caus-ing the intestines to gravitate toward the pelvis. When the liveris held by retractors air enters between the liver and intestines,making still more accessible the operative field. A dis
Preparatory and after treatment in operative cases . us which achieves the objectand mav be raised or lowered as desired. Fig. 87 shows this CHOLECYSTOTOMY 513 apparatus affixed to the operating table. By this means the liveris made to be present in the wound, and access to the cystic andcommon duct is made comparatively easy. In addition to this,the head of the table may be elevated to the extent of 35°, caus-ing the intestines to gravitate toward the pelvis. When the liveris held by retractors air enters between the liver and intestines,making still more accessible the operative field. A disadvantageof this position is that the abdominal muscles are made tense,and before the wound of approach is repaired, the horizontal po-sition should be reassumed in order to relieve tension and makepossible proper approximation of the abdominal wound. CHOLECYSTOTOMY Cholecystotomy, with fixation of the gall-bladder to the an-terior abdominal wound, has been quite abandoned in favor of tube drainage of the gall-bladder. and at times fixation of the. Fig. 321.—Drainage Arrangement Following Choubcystotomt. fundus to the anterior peritoneum. As frequently the parietalperitoneum is quite merged with the sheath of the rectus abdomi-nalis, this latter step is not always feasible nor is it, indeed, es-sential to a favorable outcome. This method of dealing with the 514 OPERATIONS ON LIVER AND FEMALE PELVIC ORGANS
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishernewyo, bookyear1910
