Arterial ligation for irremovable cancer of pelvic organs : technic adapted and amplified / by William Seaman Bainbridge.

  • Bainbridge, William Seaman, 1870-1947.
Date:
[1911?]
Catalogue details

Licence: In copyright

Credit: Arterial ligation for irremovable cancer of pelvic organs : technic adapted and amplified / by William Seaman Bainbridge. Source: Wellcome Collection.

    12/36 (page 10)
    described, the uterus may be curetted to a shell without danger of hemorrhage. Zinc chlorid or acetone may now be applied to the interior of the uterine cavity. In many cases of irremovable cancer of the pelvic organs the patient is in a condition of les¬ sened vitality, which demands the greatest pos¬ sible expedition in the operative procedure em¬ ployed. In such cases, where a long incision is required, the method suggested by Kocher, of scratching the skin of the abdominal wall pre¬ vious to making the incision, is of advantage, as it enables the operator to know just where to place the sutures, thus insuring quick closure. The through-and-through sutures of silkworm gut or silk thread are placed in the line of these scratches in the skin, and the closure completed with a few additional stitches in the skin. If desired, the peritoneum may be included in the through-and-through silk stitch. This method, which is employed by Bland-Sutton and others in general abdominal surgery, may be applied to cancer surgery in the class of cases cited. With dehydrated patients and those with low¬ ered blood pressure, hypodermoclysis may be re¬ sorted to throughout the operation, from one pint to one quart of fluid being introduced slowly under each breast at the same time, or alter¬ nately under one and then the other. In the course of the operation, should it be found that the intestines are slightly involved, it is possible to peel off the affected portion. If any raw surfaces are left they may be folded in and a row of Lembert sutures inserted, or they may be covered over with omentum, in order to prevent the dissemination of cancer cells. Case XIX illustrates this point. Wherever possible the ovaries are removed. This is done for three reasons: (1) In accord¬ ance with Beatson’s theory of the presumptive influence of ovarian irritation upon the cancer process. (2) An otherwise normal ovary may