12 GONADECTOMY IN RELATION TO THE SECONDARY 



REMOVAL OF OVARY. 



In the young female the ovary is a flat sheet of tissue, attached 

 intimately by one surface to the ventral surface of the left iliac and vena 

 cava. It may be removed in the following manner: Tear open the 

 lateral peritoneum with tenaculum and forceps and also the dorsal 

 peritoneum, which covers the ovary. Care should be taken to see that 

 all loose ends are removed. The dorsal mesentery is then freed from 

 its attachment near the iliac, extending from the anterior mesenteric 

 artery posteriorly to a point somewhat posterior to the end of the ovary. 

 This should leave the ovary and environs free from all membranes and 

 the ovary ready for removal. With a pair of fine-pointed but blunt 

 forceps the rear end is seized and gently pulled up. Sometimes there 

 is a slight projection of the ovary rearward, which is free from the iliac. 

 This greatly facilitates the starting of the ovary. If this projection is 

 wanting it will be necessary to pick patiently at the end of the ovary 

 and attempt to grasp it at its union with the iliac. Once the end is 

 started, it is possible to proceed more rapidly. As soon as a sufficient 

 amount is freed to furnish a secure grip, the end is taken firmly and a 

 gentle pull anteriorly exerted, which slowly but surely peels the ovary 

 from the iliac. It is possible to proceed in this way to a point near the 

 posterior side of the adrenal. If one attempts to go farther forward, 

 hemorrhage is pretty sure to result. 



The next step is to attack the border lying over the adrenal. This 

 is usually easily accomplished, since fear of injuring the adrenal need 

 not stand in the way, though rupture of the adrenal vein is to be avoided, 

 since the blood renders further proceedings less easy. The body of 

 the ovary is freed from the adrenal around the anterior end and down 

 the medial edge, peeling the ovary from its attachments toward the 

 iliac. With the edges of the ovary freed on all sides, the anterior end 

 is peeled back until less than a fourth of its length remains attached. 

 From this point, one of two methods may be followed. The anterior 

 end is seized with the forceps and the whole ovary stripped off, the line 

 of tension being as nearly parallel to the surface of the iliac as possible; 

 or, the forceps may be slipped beneath the ovary so that the anterior 

 and posterior ends are doubled together and stripped off as before. If 

 all has gone exactly right, there will be no hemorrhage, but a result as 

 completely successful as this is rarely obtained; more often an appar- 

 ently fatal hemorrhage ensues. If, however, a bit of cotton be laid 

 upon the site of the ovary and the bird closed up as if all were well, the 

 hemorrhage apparently ceases, for such birds rarely die, though they do 

 so unless cotton is inserted. Autopsies after fatal operations show that 

 the iliac has not been extensively ruptured, but that the wall has been 

 made very thin or even broken through in places. The blood-pressure 

 at this point is so low that the cotton is sufficient to prevent too great 

 a loss of blood, while without the cotton the blood continues to flow. 



