Pregnancy after removal of both ovaries for cystic tumour / by Alban Doran.

  • Doran, Alban H. G. (Alban Henry Griffiths), 1849-1927.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Pregnancy after removal of both ovaries for cystic tumour / by Alban Doran. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    There could be no difficulty in diagnosis. On June 14th, 1894, I operated. I will quote my notes entire.* “ Parietes very thin, no adhesions. A multilocular cyst came in sight; the omentum ran on to it, firmly adherent to its capsule. I tapped two loculi; about a pint of chocolate-coloured ovarian fluid escaped. Then I detached omentum and a coil of small intestine closely adherent to the cyst wall, somewhat to the left, and at the fundus of the cyst, at the level of the umbilicus. The mesentery formed a kind of capsule to the back and to the right side of the cyst. I separated the intestinal adhesion partly with my index nail, partly by cutting with scissors. A sponge was applied to the separated intestine ; the adhesion oozed considerably ; then the coil was kept out of the upper angle of the wound, and covered with a warm damp towel. “ The mesentery and broad ligament were detached from the cyst, the base of which was drawn up and then seen to lie close against the uterus on the left and the vermiform appendix on the right. The base of the capsule was tied with a Bantock knot (this term signifies that, after transfixion, one end of the silk was drawn through the loop and tied to the other end, according to Dr. Bantock’s practice).t An artery had been divided on the upper aspect of the base of the capsule (probably the ovarian artery, course diverted by the burrowing of the cyst) ; J it was secured by a forceps and drawn into the ligature. Two ragged pieces of adherent omentum and one tag, running into Douglas’s pouch, were tied with No. 1 silk. There was no blood in Douglas’s pouch, and the separated adhesion on the small intestine (which after the dividing of the ligatured base of [the] capsule had been returned into the abdomen covered by a sponge) had ceased to bleed. No drainage. Iodoform freely applied to wound” (an ancient custom). * I headed the case “ Ovariotomy (second, first fourteen years ago) ; Enucleation,” in my note-book. f I used, as I still use, silk No. 3, China twist. I This parenthetic sentence is part of the original text.