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Position of Ut. has nothing to do with
pains of Dysmen. 40% women
carry ut. in retro-positions so is
of no import unles tied 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.
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4. May or may not ligate sac.
5. Mattress sutures planes of Fascia
overlapping.
Not necessary to ligate sac - pay
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 high
as possible.
Cov. Sac. 1Infundib2 Cremasteric3 Intercolum
Indirect thru Ing. canal.
Direct thru Hesselbach's Trian. (Internal
to deep Epigast. Art.)
10% Iodoform in Ether for chronic
Sinus Tract. Mackechnie
Use same system in exam. for intest.
Obstruction.
1" Lift up Trans. Col &c following up.
For Volvulus, relieve twist then
shorten Mesentery.
Search for Obstruction from
known points
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