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

an abdominal incision of an ovary and Fallo

smenorrh?a, in 1872. In the same year Lawson Tait performed his pioneer operation and removed an ovary and tube for the relief of pain due to disease of the ovary. Subsequently he advocated bilateral o?phorectomy for the

the Fallopian tubes, gravid Fallopian tubes, ovarian abscess, ovarian pregnancy, prolapse of the ovary; fin

tain), as it arrests pain and the excessive output of phosphates in the urine, which is a mark

sier, safer, and affords greater relief to the patient to remove the uterus (see p. 36). When dysmenorrh?a is so severe as to need radical operation, hysterectomy is the only certain method,

of the Fallopian tubes it is difficult to completely extirpate the affected tissues wi

operators prefer to remove the ovaries and tubes through an incision i

ermed salpingo-o?phorectomy. Removal of the tube would be called salpingectomy, and the excision of the ovary, o?phorectomy. This terminology may be precise, but it i

me instruments are required, as for ovariotomy. In many of these

istended into cysts as big as a fist, or even as large as the patient's head, which are adherent to bowel, uterus, bladder, indeed everything with which they come in contact; this renders their removal tedious and exacting for the surgeon and dangerous to the patient. Alth

ecause the distended uterine section of the tube will lie on the more globular outer portion of the tube and assume the familiar shape of a chemical retort. With the fingers the adherent omentum and bowels are carefully detached, and the adhesions between the distended tube or ovary and the rectum are carefully broken through with the finger, and the

ressed into the hollow to check the oozing: the pedicle

rise to trouble, because the silk acts as a seton, an abscess forms which may open up through the abdominal wound, the rectum, or perforate into the bladder, and leads to the establishment of a sinus which persists for many months until the ligatur

unoccluded and is in the process of slowly engulfing the fimbri?. Remo

ay be exsected from the uterus: in such cases the uterine artery will be tied and

om it (Fig. 3). In chronic cases this ostium is firmly occluded (Fig. 4). Acute cases are dangerous as the

d in Section. Caseous matter has exuded through the c?lom

n accidental tear of the rectum through comparatively healthy tissues may be repaired by interrupted sutures, but when the injury is in tissues altered by chronic suppuration, the only course open to the surgeon is to drain with a wide rubber tube, and it is surprising as well

accident, and a few hours after the operation ordered 10 ounces of saline solution to be injected into

floor of the pelvis. Any vessel which is bleeding should be ligatured with thin silk, and then the recesses of the pelvis may be firmly plugged with a dab wrung out

for this purpose I find the simplest to be a narrow rubber drainage tube reaching to the bottom of the pelvis and emerging at the lower extremity of the abdominal incision. It is rarely require

l of suppurating ovaries and tubes it is better to unite the wound by a single layer of sutures throug

ges' have been removed for inflammatory lesions, acute or chronic, it may become a troublesome organ. In some instances a uterus devoid of its appendages has been attacked

e h?morrhage, pain, or a purulent discharge. Every surgeon with an ordinary experience of this class of

my when it is deemed advisable to remove the uterus with the appendages in acute infective conditions. The reasons for this modification are obvious, because in chronic conditions there is little liability for the stump to become infected, for experience teaches that though the distended tubes contain pus in chronic cases, yet on bacter

to remove the uterus unless it is obviously implicated by the disease. In s

cases the chief cause is inflammatory (septic) affections of the Fallopian tubes: other causes are tubal and ovarian pregnancy, and prolapse of the ovary. Tubal pregnanc

ovaries usually classed in Hospital Reports as 'diseased uterine appendages', I chose one hundred co

ingi

alpi

salpi

rcul

an ab

r diseased uterine appendages on 287 women. Of these four died. During the thirteen years I have filled the post of surgeon to this hospital I have performed on an average twenty o?phorectomies yearly for the diseased conditions set forth in the above table. I lost

re operation. The treatment adopted in the cases first reported was o?phorectomy, but in

uterus as well as the tubes and ovaries, but a q

e cancerous cells escape freely and implant themselves on the pelvic peritoneum and adjacent organs. In very rare inst

ostium of the Fallopian tube and the recurrence

rcinoma protruded through it and nodules of growth could be seen on the wall of the rectum at the point where the tube rested on the bowel. The pat

with primary cancer of the corresponding tube. The c?lomic ostium is open

the cyst wall and cancerous tube represented in the preceding drawi

fed with cancer, but the c?lomic ostium was completely occluded. The uterus, ovaries, and tub

n to remember that a cancerous Fallopian tube may lead to complications with an ovarian cyst. Our knowledge of primary cancer of the Fallopian tube has grown u

s big as a cocoa-nut and multilocular: the ampulla of the tube is stuffed with cancer, but the ostium is patent and a 'stream' of cancerous material has flowed over the wall of th

ncer of the Fallopian tube, is about 5%, and this is low in comparison with abdominal hysterectomy for

ere

Primary Cancer of the Fallopian Tube. Journal of O

rs Innocent and Malign

Ovary, Brit. Med.