. Clinical gyncology, medical and surgical. ry. (b) Ligation of the Pedicle.—If it is found that the fluid is colloidor is distinctly purulent, it is the practice of some operators to irrigate thecyst freely with boiled water or an antiseptic solution. This takes extratime, and is unnecessary if the adhesions have been thoroughly separatedso that the surgeon will complete the operation. Having drawn the cyst out of the abdominal wall so as to expose thepedicle, the surgeon now proceeds to ligate it. An ordinary aneurism-needle is generally used for passing the ligature : the instrument devised
. Clinical gyncology, medical and surgical. ry. (b) Ligation of the Pedicle.—If it is found that the fluid is colloidor is distinctly purulent, it is the practice of some operators to irrigate thecyst freely with boiled water or an antiseptic solution. This takes extratime, and is unnecessary if the adhesions have been thoroughly separatedso that the surgeon will complete the operation. Having drawn the cyst out of the abdominal wall so as to expose thepedicle, the surgeon now proceeds to ligate it. An ordinary aneurism-needle is generally used for passing the ligature : the instrument devisedby Dr. Clement Cleveland will be found especially convenient. (Fig. 38.) NEOPLASMS OF THE OVARIES, TUBES, AND BROAD LIGAMENTS. 709 Some surgeons prefer stout catgut, which has the advantage of being ab-sorbable material, but the majority are still rather afraid of it, on accountof the danger of slipping. Twisted Chinese silk, thoroughly sterilized, isthe most reliable material for the ligature, and is practically non-irritating. Fig. Clevelands ligature-passer. The aneurism-needle is threaded with a double ligature at least two feethmg, and is passed through the pedicle just above the round ligament,within from half an inch to an inch of the uterine cornu. The loop isnow divided, the aneurism-needle is withdrawn, the ligatures are crossedby one or two turns, and are tied with a surgeons knot. While the sur-geon is tying the ligature the assistant should lessen his traction on the cysta little. It is unnecessary to add that the knot should be tied slowly anddeliberately, not so tightly as to cut into the tissue, yet so firmly that slip-ping will be impossible. After cutting one ligature short, the two ends ofthe other should be passed around the entire pedicle, and again tied in thesame manner. The cyst is now cut away at a distance of about a quarterof an inch from the ligature, two pairs of compression-forceps havingbeen placed on the pedicle just below the point of sec
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