L'assistente chirurgico, un manuale per gli studenti, professionisti, ospedale internes e infermieri . nteriore rectus guaina è stato in-cised e viene retratto, esponendo il rectus addominali. reso parallelo alla direzione delle fibre del obliquuscxternus, espone, con l'aiuto dei riavvolgitori, che muscle it-auto. Dopo che esso è stato diviso da dissezione smussata lungo thecourse delle sue fibre, la Sharp riavvolgitori devono essere inseriti 186 l'Assistente chirurgico. In esso, al fine di esporre la obliquus internus. Dopo itsdivision, in modo simile, i riavvolgitori vengono spostate a thislayer e posto mi

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The surgical assistant, a manual for students, practitioners, hospital internes and nurses . nterior rectus sheath has been in-cised, and is retracted, exposing the rectus abdominis. made parallel with the direction of the fibres of the obliquuscxternus, exposes, with the aid of retractors, that muscle it-self. After it has been divided, by blunt dissection along thecourse of its fibres, the sharp retractors should be inserted 186 The Surgical Assistant. into it, in order to expose the obliquus internus. After itsdivision, in similar manner, the retractors are shifted to thislayer and placed in a position at right angles to their formerdirection. The transversalis, then exposed and split, is, inturn, to be drawn aside, the retractors now occupying a posi-tion parallel to the line of the body and exposing theperitoneum by a transverse slit. The trap-door dissection (known also as the Kammererincision, etc.).—The outer layer of the rectus sheath is seizedby the forceps of the operator and the assistant and dividedvertically, —the skin incision being usually vertical or some-. FlG. 66. Trap-door fncision. The belly of the rectus abdominis is drawnaside with a blunt retractor, exposing the posterior rectus sheath. The skinretractor on the same side of the wound is to be withdrawn. what oblique. This aponeurosis retracted, there is exposedthe belly of the rectus abdominis (figure 65) which, whenfreed by the surgeon, is to be drawn strongly towards themedian line with a blunt retractor (figure 66), and the skinretractor on the same side is released. The assistant thenpicks up, opposite the grasp of the operator, the posteriorlayer of the rectus sheath for incision (figure 67) ; sharp re- Abdominal Operations. 1S7 tractors are now inserted into this divided tissue, and theblunt retractor is withdrawn. The parietal peritoneum isthen ready for incision. It is very important to preserve from injury nerve fibressupplying the rectus, if they are exposed. If the incision, Ass

Parole chiave associate all'immagine

• bookcentury1900
• bookdecade1900
• booksubjectsurgery
• bookyear1905