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Position of Ut. has nothing to do with

pains of [Dyemen?]. 40% of women

carry ut. in retro-positions so is

of no import unles [tced?] down by

adhesions.

 

Inflamed irritated ovary may give

pain as far down as knee due to

irritation or pressure on obturator

nerve, as it only goes that far -

differentiate from Sciatica.

======    =======   =======

4. May or may not ligate sac.

5. Mattress sutures planes of Fascia

overlapping.

Not necessary to ligate sac - [ay

no attention to Peritoneum.

           Inguinal Hernia

1.  Cut down to Sac.

2. Open sac. before relieving constric.

    Cut up & out at int. ring.

3  Dissect up sac & tie off as tight

as possible.

Cov. Sac. 1InfundibCremasteric3 Intercolum

Indirect thru Ing. caual.

Direct thru Hes

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