Operative surgery . ble than the hands of an intelligentassistant. The ureter crosses the artery at the point of bifurcation of the vessel, andit is in little danger, since it is usually raised along with the peritoneeumand the subjacent tissue. The veins can be avoided by remembering to passthe needle away from them. This will be somewhat difficult on the rightside, owing to the large venous trunks in close contact with either side ofthe artery. If the vein obscures the arterial trunk, pressure upon it belowthe point to be ligatured will diminish its size by obstructing the venousreturn, and
Operative surgery . ble than the hands of an intelligentassistant. The ureter crosses the artery at the point of bifurcation of the vessel, andit is in little danger, since it is usually raised along with the peritoneeumand the subjacent tissue. The veins can be avoided by remembering to passthe needle away from them. This will be somewhat difficult on the rightside, owing to the large venous trunks in close contact with either side ofthe artery. If the vein obscures the arterial trunk, pressure upon it belowthe point to be ligatured will diminish its size by obstructing the venousreturn, and thus permit the easy exposure of the artery. The Fallacies.—The external iliac artery may be mistaken for the com-mon iliac artery. The fact that the sacro-vertebral prominence is above theexternal iliac artery should settle the doubt as between the two. The liga-ture may be applied too near the bifurcation, owing to the difficulty of find-ing it on account of obscure light and the intimate relation of the vessels. Fig. 183.—Ligature of common iliac artery. THE LIGATURE OF ARTERIES. 135 with each other. Careful scrutiny only will prevent this mistake fromoccurring. The author once mistook temporarily the left for the right com-mon iliac artery owing to an abnormality of the bifurcation of the , pressure made on the vessel before tying rectified the error. The Results.—Of 59 cases reported, 18 died and 41 recovered. Thirty-four of which were done for aneurism, of these, 13 lived and 21 died; 18were done for haemorrhage, 4 lived and 14 died; 7 were done for malignantdisease, 1 lived and 6 died. Of the 59 cases, 53 were done before 1883, ofthese, 35 died and 18 recovered. Six were done aseptically since 1883, alldied. Ligature of the Internal Iliac Artery.—The internal iliac is ligatured tocontrol the circulation of a pelvic viscus and to arrest of haemorrhage. The Anatomical Points.—The internal iliac artery is about an inch anda half in length, and extends
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Keywords: ., bookauthorbryantjosephdjosephde, bookcentury1900, bookdecade1900
