Diseases of the ovaries : their diagnosis and treatment / by T. Spencer Wells.

  • Wells, Spencer, 1818-1897.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the ovaries : their diagnosis and treatment / by T. Spencer Wells. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    CHAPTER XV. TREATMENT OF THE PEDICLE, SPONGING OF THE PERITONEUM, AND CLOSURE OF THE WOUND. Pedicle. — The emptied cyst, or the tumour sufficiently broken up to admit of its being drawn through the opening in the abdominal wall, having been freed from any portions of omentum or intestine adhering to it, must be carefully sup- ported by the assistant who stands to the left of the operator, while the attachments which connect the root or base of the tumour with the side of the uterus are examined. For the sake of convenience, the attachment, whether long, narrow, and cord- like, or short, thick, and broad, may be considered under the common designation of pedicle. It consists of the Fallopian tube, often much elongated, the broad ligament often con- siderably thickened, the utero-ovarian ligament, occasionally hypertrophied into a large fibroid stem, and the round ligament. Sometimes the round ligament is so convoluted that a double curve of it may be included in the pedicle, but it is often quite free from it. Occasionally, the utero-ovarian ligament and the Fallopian tube are not connected by the broad ligament; a considerable space may intervene between them, so that they appear as two pedicles to one tumour. The pedicle always contains large blood vessels; occasionally, the veins are so large and distended that they resemble the intestines of a rabbit. The origin and distribution of the uterine and spermatic arteries have been described in the first chapter, and some of the venous plexuses have been shown in a drawing. Numerous lymphatics, after a devious course and many inosculations passing between the ovary, the tube, and the broad ligament to the lumbar plexus, are also enclosed in the pedicle, and nerves of considerable size accompany the vessels. I have seen a nerve quite as large as the radial in part of the pedicle left above the clamp. Before the tumour is cut away the pedicle must be secured;