ABLATION OF TUMOKS. 



209 



Fig. 242.— 2d Step. Fig. 243.-3(1 Step. 



extremities come out by the same opening (Fig. 243), while a sec- 

 ond thread, f f, is free between the superior and the two lower 

 thii'ds of the tumor (Fig. 244). 



The manipulations for the superior third of the growth are 

 repeated for the lower third, with another thread, and the middle 

 third is then surrounded by two parallel threads A, B and C, D 

 (Fig. 245). 



Fig. 244.— 4th Step. Fig. 245.— 5th Step. 



Both of these two threads are passed into the curved needle, 

 and it then becomes easy to carry under the skin the extremity of 

 the thread B to the opening D, and the thread A to the opening 

 C, where it will be tied to thread B. AU the threads A, B, C, D 

 will thus form a loop embracing the middle third of the growth, 

 as the other threads wiU surround the upper and the lower thirds. 

 All the ligatures can be then tied to the required degree and the 

 operation is completed (Figs. 246, 247). 



Fig. 216.— The Ligatures in 

 Position. 



Fig. 247.— The Ligature 

 Secured. 



When the ligature that is to apply the necessary constriction 

 upon the base of the tumor is in place, it must be tied more or 



