ABDOMINAL CAVITY 445 



wards, immediately to the left of the line of attachment of the falciform 

 ligament. On the lower surface the knife must be carried backwards along 

 the umbilical fossa, close to its left margin, and it must emerge on the 

 posterior surface in the fossa for the ductus venosus and close to the left 

 margin of that fossa (see Fig. 170). 



The portion of liver removed must be carefully preserved so that it may 

 afterwards be reattached to the right lobe. 



Omentum Minus (The Lesser Omentum). The lesser 

 omentum is a fold of peritoneum which connects the 

 lesser curvature of the stomach and the first part of the 

 duodenum with the margins of the porta hepatis (O.T. 

 transverse fissure) on the lower surface of the liver, and 

 with the margins of the fossa for the ductus venosus on the 

 posterior surface. Its lower and left margin is attached 

 to the stomach and duodeum ; its upper margin is attached 

 to the liver ; and its right border is free and forms the 

 anterior boundary of an aperture, the foramen epiploicum 

 (O.T. foramen of Winslow), which connects the cavity of the 

 larger part of the peritoneal sac, the greater sac, with the 

 smaller part, the bursa omentalis. The guide to this aperture 

 is the gall-bladder, and if the dissector carries his finger 

 upwards and backwards along the lower surface of the gall- 

 bladder to its neck, and then turns it backwards and to the 

 left he will find that it passes through the epiploic foramen 

 into the omental bursa. 



The lesser omentum contains a large number of important 

 structures. Two of the arteries which supply the stomach, 

 the hepatic artery and the portal vein which carry blood to 

 the liver, the bile ducts through which the bile is conducted 

 to the duodenum, and numerous nerves, lymph vessels, and 

 lymph glands lie between its layers. The dissector should 

 now display these structures by removing the anterior layer 

 of the fold. It is not probable that he will be able to remove 

 it in a continuous sheet, but he must take care not to destroy 

 the posterior layer. 



Dissection. Commence at the upper border of the stomach, immediately 

 below the oesophagus, and expose the left gastric artery, follow this down- 

 wards to its anastomosis with the right gastric branch of the hepatic artery, 

 and upwards to the point at which it gives off its cesophageal branch ; 

 trace the latter along the oesophagus to the diaphragm. Remove the 

 peritoneum from the front of the oesophagus and find the left vagus nerve, 

 which descends on the front of the lower end of the oesophagus. Trace 

 the terminal branches of the nerve to the wall of the stomach and into the 

 lesser omentum. Whilst cleaning the left gastric artery the dissector may 

 possibly see some of the cardiac lymph glands of the stomach at the upper 



