A System of Operative Surgery, Volume 4 (of 4)

CHAPTER IX

OPERATIONS UPON THE UTERUS DURING PREGNANCY, PARTURIENCY, AND PUERPERY

Cæsarean Section, 69; Immediately after the Death of the Mother, 72. Ovariotomy and Hysterectomy during Pregnancy and in Labour, 73. Ovariotomy during the Puerperium, 76. Fibroids and Pregnancy, 77. Pregnancy with Cancer of the Cervix, 82. Concurrent Uterine and Tubal Pregnancy, 82. Pregnancy with Tumours growing from the Pelvic Walls, 83. Operations for Puerperal Sepsis, 83 69-85

CHAPTER X. Operations for Injuries of the Uterus

OPERATIONS FOR INJURIES OF THE UTERUS

Gynæcological, 86. Obstetric, 87; to the Pregnant Uterus, 89; to the Gravid Uterus in the course of an Abdominal Operation, 89. Bullet Wounds of the Pregnant Uterus, 90. Stab-wounds of the Pregnant Uterus, 91 86-92

CHAPTER XI

THE AFTER-TREATMENT, RISKS, AND SEQUELÆ OF ABDOMINAL GYNÆCOLOGICAL OPERATIONS

After-treatment of Abdominal Operations, 93. Complications of Abdominal Gynæcological Operations--Metrostaxis, 95; Bed-sores, 95; Post-anæsthetic Paralysis, 95; Giving way of the Wound, 96; Hæmorrhage, 97; Intrapelvic Hæmorrhage, 98; Pneumonia, 99; Parotitis, 99; Thrombosis, 101; Pulmonary Embolism, 101; Foreign Bodies left in the Abdomen, 105; Tetanus, 107; Injury to the Intestines, 109; Intestinal Obstruction, 110; Perforating Ulcer of the Stomach and Small Intestine, 111; Injuries to the Bladder, 111; to the Ureter, 112. The fate of Ligatures, 117. Post-operative Kraurosis, 120. The Cicatrix, 120 93-122

PART II. Vaginal Gynæcological Operations

VAGINAL GYNÆCOLOGICAL OPERATIONS

By JOHN PHILLIPS, M.A., M.D. (Cantab.), F.R.C.P.

Professor of Obstetric Medicine, King’s College, London; Obstetric Physician and Gynæcologist to King’s College Hospital.

CHAPTER XII. Preparation of the Patient for Perineal and Vaginal Operations:

PREPARATION OF THE PATIENT FOR PERINEAL AND VAGINAL OPERATIONS: OPERATIONS FOR INJURIES TO THE PERINEUM AND PELVIC FLOOR

Preparation of the Patient, 125. Operations for Repair of a Complete Laceration of the Perineum, 127. Operation for Laceration of the Pelvic Floor, 132 125-133

CHAPTER XIII. Operations Upon the Urethra and Bladder

OPERATIONS UPON THE URETHRA AND BLADDER

Extirpation of a Urethral Caruncle, 134. Operations for Incontinence following Labour, 134; for Vesico-vaginal Fistula, 135; for Recto-vaginal Fistula, 139; for Cystocele, 140 134-141

CHAPTER XIV. Operations Upon the Vulva and Vagina

OPERATIONS UPON THE VULVA AND VAGINA

Operations upon Bartholin’s Glands, 142. Operations for Atresia of the Hymen and the Vagina, 143. Dilatation of the Vulval Orifice, 143. Colpotomy, 144; Anterior, 145; Posterior, 147; Lateral, 148 142-148

CHAPTER XV. Operations Upon the Uterus

OPERATIONS UPON THE UTERUS

Passage of the Uterine Sound, 149. Reposition of a Chronic Uterine Inversion, 151. Curetting the Uterus, 152. Dilatation of the Cervix, 156--Rapid Dilatation, 157; Gradual Dilatation, 159. Operations for Hypertrophy of the Cervix, 160. Trachelorrhaphy, 161. Vaginal Fixation, 164 149-164

CHAPTER XVI. Operations for New Growths of the Uterus

OPERATIONS FOR NEW GROWTHS OF THE UTERUS

For Uterine Fibro-myomata, 165--for Pedunculated Tumours, 165; for Sessile Tumours, 166; for Interstitial Tumours, 167. Vaginal Hysterectomy, 167--for Carcinoma, 168; for Fibroids, 173 165-173

SECTION II. Ophthalmic Operations by M. S. Mayou, F.r.c.s. (eng.)

OPHTHALMIC OPERATIONS By M. S. MAYOU, F.R.C.S. (Eng.)

Assistant Surgeon to the Central London Ophthalmic Hospital; Ophthalmic Surgeon to the Children’s Hospital, Paddington Green.

CHAPTER I. General Considerations Applicable to Operations Upon the Eye

GENERAL CONSIDERATIONS APPLICABLE TO OPERATIONS UPON THE EYE

General Preliminaries to an Operation, 177. Local Preparation of the Patient, 80. Making and Healing of Wounds in the Globe, 182--Purification of Hands, 182; of Instruments, 183; Direction of Incision, 183; Position of Incision, 184; Dressings, 186; Bandaging, 186 177-186

CHAPTER II. Operations Upon the Lens

OPERATIONS UPON THE LENS

Surgical Anatomy, 187. Discission or Needling, 189--for Cataract, 189; for High Myopia, 190. Capsulotomy, 192. Evacuation, 194. Evulsion of the Capsule, 195. Extraction of the Lens, 195. Modifications, 201; Delivery of the Lens by Irrigation, 203; Extraction of the Lens in its Capsule, 204; Subconjunctival Extraction, 204. Couching, 209 187-210

CHAPTER III. Operations Upon the Iris

OPERATIONS UPON THE IRIS

Iridotomy, 211. Alternative Methods--Kuhnt’s Operation, 212; Ziegler’s, 213. Iridectomy--Optical Iridectomy, 214; Glaucoma Iridectomy, 217--for small Growths of the Iris, 225; for Prolapse of the Iris, 225. Transfixion of the Iris, 226. Division of Anterior Synechiæ, 227 211-227

CHAPTER IV. Operations Upon the Sclerotic

OPERATIONS UPON THE SCLEROTIC

Anterior Sclerotomy, 228. Cyclo-dialysis, 229. Sclerectomy, 231. Posterior Sclerotomy, 232. Paracentesis of the Anterior Chamber, 233. For Penetrating Wounds of the Globe, 234. Electro-magnet Operations--with Small Magnet, 237; with Giant Magnet, 238 228-239

CHAPTER V. Operations Upon the Cornea and Conjunctiva

OPERATIONS UPON THE CORNEA AND CONJUNCTIVA

Removal of a Foreign Body from the Cornea, 240. Cauterization of the Cornea, 240. Operations for Conical Cornea, 241. Removal of Tumours involving the Cornea, 243. Tattooing the Cornea, 243. Scraping Calcareous Films, 243. Operations upon the Conjunctiva--Removal of Foreign Bodies, 244; for Pterygium, 244; Expression, 245; Conjunctivoplasty, 245; Removal of Tarsal Cysts, 246 240-246

CHAPTER VI. Operations Upon the Extra-Ocular Muscles

OPERATIONS UPON THE EXTRA-OCULAR MUSCLES

Squint Operations, 247. Tenotomy, 248. Advancement, 251 247-254

CHAPTER VII

ENUCLEATION OF THE GLOBE AND ALLIED OPERATIONS

Enucleation, 255. Evisceration, 257. Mules’s Operation, 259. Frost’s Operation, 259. Operations upon the Socket after Removal of the Eye--Paraffin Injection, 260. Operations for Restoration of a Contracted Socket--Skin-grafting, 261; Inclusion of Flaps (Maxwell’s Operation), 261 255-262

CHAPTER VIII. Operations Upon the Eyelids

OPERATIONS UPON THE EYELIDS

Surgical Anatomy, 263. Suture of Wounds of the Eyelids, 263. Operations for Ankyloblepharon, 264; for Symblepharon, 264. Upon the Palpebral Aperture, 265--Canthoplasty, 265; Canthotomy, 265; Canthorrhaphy, 265; Tarsorrhaphy, 266. Ptosis Operations, 267; Shortening the Eyelid by Excision of a portion of the Tarsal Plate, 267. Attachment of the Lid to the Occipito-frontalis Muscle, 268. Advancement of the Levator Palpebræ Muscle, 272. Grafting a portion of the Superior Rectus into the Lid, 273 263-274

CHAPTER IX. Operations for Entropion, Repair of the Eyelids, Trichiasis, and

OPERATIONS FOR ENTROPION, REPAIR OF THE EYELIDS, TRICHIASIS, AND ECTROPION

Electrolysis, 275. Skin and Muscle Operation, 275. Rectification of a Faulty Curvature of the Tarsus--Burow’s Operation, 276; Streatfield’s Operation, 277. Transplantation of the Lash-bearing Area--Arlt’s Operation, 278. Ectropion Operations, 279--for Passive Ectropion, 280; Snellen’s Suture Method, 280; Fergus’s Operation, 281; Kuhnt’s Operation, 281; Argyll Robertson’s Operation, 282. For the Active or Cicatricial Form, 284; VY Operation, 284; Denonvillier’s Operation, 285; Fricke’s Operation, 285; Thiersch’s Skin-grafting, 287. Repair of large Losses of Substance from the Eyelids, 287; De Vincentiis’ Operation, 287; Dieffenbach’s Operation, 288 275-289

CHAPTER X. Operations Upon the Lachrymal Apparatus

OPERATIONS UPON THE LACHRYMAL APPARATUS

For the Relief of Lachrymal Obstruction, 290--Dilatation of the Canaliculus, 290; Slitting the Canaliculus, 291; Syringing the Lachrymal Duct, 292; Probing the Lachrymal Duct, 292; the Insertion of Styles, 293. For Obliteration of the Canals, 294; Obliteration of the Canaliculi, 294; Excision of the Lachrymal Sac, 294. Opening a Lachrymal Abscess, 297. Operations upon the Lachrymal Gland--Removal of the Palpebral Portion, 298; Removal of the Orbital Portion, 299. Operations upon the Orbit--Exploration of the Orbit (Krönlein’s Method), 299; Evisceration of the Orbit, 301; Opening an Orbital Abscess, 301 290-301

SECTION III. Operations Upon the Ear

OPERATIONS UPON THE EAR

By HUNTER F. TOD, M.A., M.D. (Cantab.), F.R.C.S. (Eng.)

Aural Surgeon to the London Hospital.

CHAPTER I

EXAMINATION OF THE EAR: GENERAL CONSIDERATIONS WITH REGARD TO OPERATIONS

Examination of the Ear, 305--Sources of Illumination, 305; Technique of Examination, 306; Method of cleansing the Ear, 307. General Considerations with regard to Operations--Preliminary Surgical Toilet, 309; Anæsthesia, 310. Position of Patient and Surgeon, 313 305-313

CHAPTER II. Operations Upon the External Auditory Canal

OPERATIONS UPON THE EXTERNAL AUDITORY CANAL

Operations for Furunculosis, 314. Removal of Exostoses from the External Meatus, 316. Removal of Foreign Bodies--by Syringing, 322; by Instruments, 323; by Post-aural Incision, 326; by Operation upon the Mastoid, 327. Operations for Stenosis of the External Meatus, 328. Operations for Atresia, 330; for Aural Polypus, 331 314-334

CHAPTER III

OPERATIONS UPON THE TYMPANIC MEMBRANE AND WITHIN THE TYMPANIC CAVITY

Surgical Anatomy of the Tympanum, 335. Paracentesis, 336. Artificial Perforation of the Tympanic Membrane, 340. Division of the Anterior Ligament, 341. Division of the Posterior Fold, 341. Intratympanic Operations, 342; Division of Adhesions, 342; Tenotomy of the Tensor Tympani, 346; Tenotomy of the Stapedius, 347. Removal of Granulations from the Tympanic Cavity, 348. Operations upon the Ossicles--Direct Mobilization, 349; Removal of the Ossicles, 351 335-363

CHAPTER IV. Operations Upon the Eustachian Tube

OPERATIONS UPON THE EUSTACHIAN TUBE

Catheterization, 364. Passing of the Eustachian Bougie, 369. Washing out the Tympanic Cavity through the Eustachian Tube, 372 364-372

CHAPTER V

OPERATIONS UPON THE MASTOID PROCESS: WILDE’S INCISION AND SCHWARTZE’S OPERATION

Surgical Anatomy, 373. History of the Mastoid Operation, 375. Wilde’s Incision, 377. Schwartze’s Operation, 378. Treatment of Special Conditions--in an Infant, 389; Subperiosteal Abscess, 389; Bezold’s Mastoid Abscess, 389; Necrosis, 390; Osteomyelitis, 390 373-390

CHAPTER VI. The Complete Mastoid Operation

THE COMPLETE MASTOID OPERATION

Methods of Operation, 392; Küster-Bergmann (Schwartze-Stacke) Operation, 393; Wolf’s Operation, 396; Stacke’s Operation, 397; Preservation of the Ossicles and Tympanic Membrane, 399. The Formation of Post-meatal Skin Flaps, 401. Closure of the Wound, 404. Skin-grafting after the Mastoid Operation, 405. After-treatment of the Case, 410. Difficulties and Dangers of the Operation, 412. Results, 415 391-416

CHAPTER VII. Operations Upon the Labyrinth

OPERATIONS UPON THE LABYRINTH

General Considerations, 417. Indications, 417. Surgical Anatomy, 420. Methods of Operating, 421; Curetting a Localized Lesion of Wall, 421; Opening the Vestibule, 422; Removal of the Cochlea, 424; Extirpation of the Labyrinth, 425 417-428

CHAPTER VIII

OPERATIONS FOR EXTRA-DURAL ABSCESS AND MENINGITIS OF OTITIC ORIGIN

On Intracranial Complications in General, 429. Operations for Extra-dural Abscess, 430. Operations for Meningitis of Otitic Origin, 433 429-438

CHAPTER IX. Operations for Lateral Sinus Thrombosis of Otitic Origin

OPERATIONS FOR LATERAL SINUS THROMBOSIS OF OTITIC ORIGIN

General Considerations, 439. Exposure of the Lateral Sinus, 440. Opening of the Lateral Sinus, 442. Ligature of the Jugular Vein, 446. Exposure of the Jugular Bulb, 454 439-458

CHAPTER X. Operations for Intracranial Abscess of Otitic Origin

OPERATIONS FOR INTRACRANIAL ABSCESS OF OTITIC ORIGIN

Indications, 459. Operation, 460. After-treatment, 469. Complications, 469. Prognosis and subsequent Progress, 470. Recurrence of Symptoms, 471 459-471

SECTION IV. Operations Upon the Larynx and Trachea

OPERATIONS UPON THE LARYNX AND TRACHEA

By W. DOUGLAS HARMER, M.C. (Cantab.), F.R.C.S. (Eng.)

Surgeon to the Throat and Nose Department, St. Bartholomew’s Hospital.

CHAPTER I. Endolaryngeal Operations

ENDOLARYNGEAL OPERATIONS

Indications, 475. Operation by Indirect Laryngoscopy, 477. Operation by Direct Laryngoscopy, 479 475-486

CHAPTER II

EXTRA-LARYNGEAL OPERATIONS

Thyrotomy, 487. Hemi-laryngectomy, 495. Anatomy of the Laryngeal Lymphatics, 496. Total Laryngectomy, 498. Comparative Results of Extra-laryngeal Operations, 502. Infrathyreoid Laryngotomy, 510 487-516

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