. Operative gynecology. und; they are thenreplaced in the abdomenand held there by a gauze A good - sized cuff ofperitoneum is then freed,dissected off from the innersurface of the ring, andturned into the abdomen,and the gauze taken outand the peritoneum closedby a continuous catgut fibrous ring in a small hernia must now be dissected away, exposingthe edges of the recti muscles ; any extraded peritoneum lining the sac or sac-culi must also be removed with scissors and forceps. The opening is then closedby several mattress sutures of silkworm gut laid close together, so as to brin
. Operative gynecology. und; they are thenreplaced in the abdomenand held there by a gauze A good - sized cuff ofperitoneum is then freed,dissected off from the innersurface of the ring, andturned into the abdomen,and the gauze taken outand the peritoneum closedby a continuous catgut fibrous ring in a small hernia must now be dissected away, exposingthe edges of the recti muscles ; any extraded peritoneum lining the sac or sac-culi must also be removed with scissors and forceps. The opening is then closedby several mattress sutures of silkworm gut laid close together, so as to bringthe muscles and the fascia on the right and the left sides into snug apposition ;after this the subcutaneous fat is united, and then the skin is closed with a sub-cuticular catgut suture. I have found it necessary to relieve several large umbilical hernife by open-ing the sac and simply pushing the finger between the peritoneum and the lowerborder of the ring and cutting the ring down from 3 to 6 centimeters in the me-. FiG. 549.—Third Step. The sac incised, as indicated in the last figure, exposing its con-tents, which are reduced; the sac is then loosened from its sur-rounding attachments and from the round ligament and excisedclose to the provisional ligature.
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
