Ovarian tumors, and remarks on abdominal surgery : with the result of 50 cases / by Edward Borck.

  • Mathias Adolph Edward Borck
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Ovarian tumors, and remarks on abdominal surgery : with the result of 50 cases / by Edward Borck. 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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    I can very well get along with two good assistants. I select them be- fore hand, and send this card: St. Louis, 188 Dr The undersigned requests your presence to assist him in an operation for at on the day of. 188...., at o'clock Duty For which you will receive a cash fee of § Providing that you have not been in a dissecting room or engaged at an autopsy, and have not seen or attended or have been in contact vjith any contagious or infectious diseases whatsoever, for the last 24 hours previ- ous to date of operation. Taking due precautions of having hands and body as well as garments thoroughly surgically clean. Operating gown will be furnished. Be punctual, as no one will be admitted to the operating room after the operation has begun, nor will anyone be permitted to leave the room until the operation and toilet is completed. Truly yours, EDW. BORCK, M. D. PLEASE ANSWER-. Cor. Ninth & Salisbury Sts. Never neglect to put in the amount of fee you will pay cash, (cases of charity excepted) and the answer you receive will almost invariably read “I will be on hand,” aud they are ou hand and will remain until you thank them for their service and right and justice will prevail on both sides. Neither neglect to invite and select the family physician or the physician who kindly sent you the case to be one of jmnr assistants. Everything being ready, the patient is brought in, laid upon the bed, covered and chloroformed. The assistant will gently support the abdo- men with his expanded hands. You begin your incision through the skin a little below the umbilicus in the linea alba and carry it down to the pubis, then divide the cellular and adipose tissue, using your groove director, layer after lajmr, until you come to the peritoneal covering; if you miss the median line move your director from side to side and you will find it again. However, I think there.is no harm, perhaps an advan- tage, in cutting throngh the rectus muscle. Having reached the perito- neum, stop and wait until all hemorrhage has ceased. Then pick up the peritoneal layer with a forceps, nick with the knife and divide it the whole length. The cyst will now be exposed. You can recognize it by its bluish appearance; if you are not sure examine it closely, you will see whether there are any adhesions and may use the sound for that purpose. If you have not room enough lengthen your incision. Having satisfied yourself about that, the next step will be to empty the cyst. Let us suppose this bladder which lies be- fore us and which is filled with water, to be a] cyst. You take the elevator and intro- duce it thus: see Fig. 5. Now take the trocar, thrust it into the cyst, between the prongs Fig. 5. and fingers. See Fig. 6. 'The advantage of this method is: no fluid can escape from the cyst and the sack empties