File:Gynecology (1916) (14757168066).jpg

Identifier: gynecologygrav2 (find matches)
Title: Gynecology
Year: 1916 (1910s)
Authors: Graves, William Phillips, 1870-1933
Subjects: Gynecology Genital Diseases, Female Women Gynecology
Publisher: Philadelphia and London : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Fig. 388.—Transplantation of Fascia Lata for Postoperative Hernia (Bartletts Method).Showing method of dissecting fascia from thigh. in the form -of a parallelogram and placed in warm normal salt solution untilneeded. The wound of the leg is closed. The abdominal wound is then uncovered. Without making any incisionin the fascia the hernial protrusion is inverted and the edges of the turned-inportion sutured with catgut, care being exercised not to pierce the fascia sodeeply as to injure a loop of intestine that may be closely adherent beneath. OPERATIONS ON THE ABDOMINAL WALL 683 The flap of fascia lata is removed from the saline solution and cut in thecenter, the two pieces being sewed together so that the fibers of both pieces inthe new parallelogram thus formed will run transversely instead of longitudinally,as in the first piece. A glance at Fig. 389 will explain this point. This maneuver
Text Appearing After Image:
\ S N^.P: Graves- Fig. 389.—Transplantation of Fascia Lata For Abdominal Hernia (Bartletts Method).The piece of fascia lata removed from the thigh has been cut in two and the pieces laid side-wise so that the direction of the fibers will be at right angles to those of the abdominal fascia. Thelayer of fascia covering the hernia has been reduplicated by a running suture, the ends of which canbe seen above and below the transplanted fascia. is carried out- so that the fibers of the transplanted flap will not coincide indirection with those of the abdominal fascia covering the hernia. The layerof fascia lata is then stitched to the abdominal wall over the inverted hernia(Fig. 389). The wound is closed with a stab-wound drain placed as in Fig. 383.The denuded muscles of the leg become rapidly invested in a new sheath. OPERATIONS ON THE KIDNEY In operating on kidneys the incision and proper exposure of the kidney is ofthe greatest importance, for if this is not properly done the operatio

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