Pathology and treatment of diseases of women (1912) (14781715405)

Identifier: pathologytreatme00mart (find matches)

Title: Pathology and treatment of diseases of women

Year: 1912 (1910s)

Authors: Martin, August Eduard, 1847- Jung, Ph. (Philipp Jacob), 1870-1918

Subjects: Gynecology Gynecology

Publisher: New York : Rebman company

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

ision is executed transversely or vertically de-pends on the custom of the operator. If the tumor does not immediatelypress forward during the vaginal operation, it may be carefully presseddownward from above, or it may be seized at the pedicle with a bullet-forceps, in order to deliver it with its lower surface. Finally, the tumormay be grasped with a tenaculum forceps, after protecting the surround-ings with gauze sponges. If it tears in this process the escaping con- THE DISEASES OF THE OVARIES 413 tents must be completely kept away from the peritoneum by gauzesponges. The cases of intraligamentous development of the tumor offer apeculiar difficulty. At times the portion projecting into the abdominalcavity is surrounded by peritoneum, as with a neck frill. After abdom-inal exposure this portion projecting into the abdominal cavity is incisedbeneath this frill and the peritoneum is split, the finger is pushed be-tween the tumor and its bed, and the former enucleated. If possible the

Text Appearing After Image:

_Fig. 183.—Abdominal Ovariotomy. The cut surface of the pedicle stump is coveredwith peritoneum by a continued catgut suture through the cut edges. vessels are ligated before their separation. The hemorrhage must becompletely controlled in every instance. Attention must be paid to theureters. The emptied cavity usually collapses; it suffices to suture thewound in the peritoneum with a continuous stitch. If a cavity is large,the suturing is done in rows. If blood oozes continuously from the tornedges of the cavity, as sometimes occurs, then the cavity is drained withgauze through the posterior vaginal vault, and the cavity packed withgauze so that the hemorrhage is arrested. The peritoneum is closedabove by a suture. In pseudo-ligamentary development, that is, when a part of the surface 414 DISEASES OF WOMEN of the tumor is adherent by peritonitis adhesiva to the posterior surfaceof the ligamentum latum and other parts of the excavatio recto- or vesico-uterina, a cavity with torn wal

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1912

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