Removal of large fibro-cystic tumour of the uterus : recovery / by J. Knowsley Thornton.

  • Thornton, J. Knowsley.
Date:
[1878?]
Catalogue details

Licence: Public Domain Mark

Credit: Removal of large fibro-cystic tumour of the uterus : recovery / by J. Knowsley Thornton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    I found that the pelvic portions of the tumour were chiefly cystic. There were many cysts, all much of a size, and so thin and universally adherent that I was obliged to break them up in situ, much cyst-contents and blood pouring over the uterus, ovaries, and rectum. Having cleared the pelvis and separated some parietal and intestinal adhesions, I turned the tumour over to the left side and downwards, so that Mr. Meredith supported it on the left thigh of the patient. I was now able to see what I had already examined by touch—a thick vascular pedicle springing from the back and left angle of the fundus uteri, so that it was possible to include the whole in the largest Spencer Wells clamp without including the left tube or ovary. I transfixed it with a strong carbolised whipcord ligature, and applied a temporary clamp, and cut the tumour away in order to be able to see more exactly where the permanent clamp should be applied. Having put on the permanent clamp, I tightened it as the temporary clamp was removed, and the whipcord cut away by Mr. Meredith. Not a drop of blood was lost during this part of the operation, except what was in the tumour, and Mr. Doran remarked on the immediate improvement in the condition of the patient when the tumour circulation was thoroughly cut off by the first clamp and ligature. A good deal of sponging was necessary, and some troublesome oozing was still going on from the parietal and omental adhesions high up in the abdomen when I closed the wound. I hesitated at first whether to use a glass tube for drain- age, but feeling confident as to my antiseptic precautions during the operation, and thinking that discharge of the serum and blood would further weaken the patient, and also that it would be very difficult to keep all aseptic if I had a tube opening beside the clamp with such a large stump, I decided to entirely close the peritoneum at once. I dressed as usual with carbolised gauze, taking care that the surface next the wound was well moistened with the lotion before I applied it; because dust which may have settled on the gauze just before its application has not had time to beaded upon by the carbolic acid in the gauze, and may hence be applied