File:The Principles and practice of gynecology - for students and practitioners (1904) (14765825144).jpg

Identifier: principlespracti00dudl (find matches)
Title: The Principles and practice of gynecology : for students and practitioners
Year: 1904 (1900s)
Authors: Dudley, E. C. (Emilius Clark), 1850-1928
Subjects: Gynecology
Publisher: Philadelphia : Lea Brothers & Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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er hook willbring up the ligament itself. The tissue thus brought into view is ao-ravTsh-colored mass of fat, which contains anastomosing blood-vesselsanci the ligament, with its accompanying ilio-inguinal nerve and vessels.The operator who attempts to find the ligament as Alexanderdirected, by cutting down through the mass of fat, will find himselfembarrassed by the resultant bleeding and the disarrangement of thecontents of the canal. He may for hours grope blindly about thereo-ion among a variety of structures which marvellously resemble,bift are not, tlie ligament.^ The earlier operators, who cut directly tothe external ring,\vhere the ligament spreads out just before passing,fan-shaped, to the pubes and labia, frequently were misled, and there-fore often unsuccessful. Drawing Out the Ligaments in Alexanders Operation.The mass, having been picked up by the hook, is now spread outon the finger, and the ligament, invested in its fascial sheath, is recog- FiGURE 386. *. d ■•■ P
Text Appearing After Image:
d the internal ring; c, external ring; light dotted lines between indicate the position of theinguinal canal, the heavy dotted lines below indicate the direction ot Poupart s ligament.a shows position of skin incision ; e, e. indicate retractors by which the tissues divided by theincision are separated down to the tendon of the external oblique ; 6 shows the small incisionin the tendon of the external oblique near the internal ring; P, pubes.^ nized by its cord-like appearance. On making a longitudinal slit inthe sheath, the smooth glistening pink surface of the round ligament 1 Lapthorn Smith. The Medical News. September 29, 1896. 2 Modified from Kellogg. Proceedings Michigan State Medical Society, 1889. 674 , DISPLACEMENTS. appears. From this time the operation on that side is simple. Assoon as the identity of the ligament is clearly established by the factthat it can be readily pulled out from the direction of the internalring—that is, made to run —it is secured from slipping b

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