The diagnosis and treatment of diseases of women (1907) (14781570561)

Identifier: diagnosistreatmecros (find matches)

Title: The diagnosis and treatment of diseases of women

Year: 1907 (1900s)

Authors: Crossen, Harry Sturgeon, 1869-

Subjects: Genital Diseases, Female Gynecology Gynecology Women Generative organs, Female

Publisher: St. Louis : Mosby

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

m b to the internal ringis so short (about one inch) that no puckering suture is necessary. This point isfurther explained in Fig. 603. (Crossen—Journal of American Medical Association.) track and out at the abdominal wound (Fig. 603). The loop of ligament broughtout is now caught and held by an ordinary tenaculum-forceps, while the right liga-ment is brought out in a similar manner with the puncturing tenaculum-forceps.After the ligaments are brought into position the tension is adjusted. Itmay be necessary to bring out a little more of the proximal portion ora little more of the distal portion, the former to bring the fundus well CHOICE OF OPERATION FOR RETRODISPLACEMENT 617 forward and the latter to close effectively any space that may exist be-tween the distal portion and the parietal peritoneum. By paying attention tothis latter point the peritoneal puncture may he made a considerable distance fromthe internal inguinal ring without leaving any opening through which an intestina

Text Appearing After Image:

Fig. 603. The Left Round Ligament Drawn into Place. Notice that the direction ofthe pull on the uterus is changed from lateral to anterior. At the same time there isno large opening between the distal portion of the round ligament and the anterior ab-dominal wall requiring a suture, as in the regular Gilliam-Ferguson operation. Thedistance from the peritonea! exit of the new ligament to the lateral edge of tlie peri-toneal cavity at this level is so small (represented in the corner sketch in Fig. 602 by thedistance from b to tlie internal inguinal ring) that it is closed by moderate traction on thedistal portion of the round ligament loop appearing in the wound. If it is desired to bringthe uterus farther forward the proximal portion of the ligament is pulled on. If theperitoneum becomes tense before there is sufficient tension on the round ligament to bringthe uterus well forward, the peritoneum over the ligament loop may be incised and theligament itself grasped and drawn out as des

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1907

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