104 VAGINAL OVARIOTOMY IN THE MARE 



quent infection of the vaginal wound. The vagina may 

 with benefit be flushed out mechanically with 0.6% salt or 

 soda solution. 



Wash away the sublimate solution with a tepid 0.6 per 

 cent soda bicarbonate solution, and fill the vulvo-vaginal 

 canal with the same. After thorough disinfection of the 

 hands and arms, remove the disinfectants by washing in 

 sterile soda solution, which at the same time renders the 

 hand unctuous and readily introduced through the vulva. 

 Armed with the guarded sterilized scalpel. Fig. 45, intro- 

 duce the right hand into the vagina promptly and when it 

 is well "ballooned," unsheath the knife. Place it just 

 above the os uteri parallel to the long axis of the uterus, 

 a few mm. to the right or left of the median line in order to 

 avoid a loose fold of mucous membrane generally existing 

 there. Hold the blade vertical, that is, with the cutting 

 surface parallel to the longitudinal muscular fibers of the 

 vagina, and guarding the possible extent of its introduction 

 with the thumb and fingers, push it directly forward in a 

 straight line with a quick thrust through vaginal mucosa, 

 the muscular walls and the peritoneum, until the disap- 

 pearance of resistance indicates that the latter has been 

 penetrated. This is the most critical step in the operation. 



If the hand is introduced into the vagina immediately 

 after the injection of the sterile saline solution, the vagina 

 will generally be found " ballooned " or will quickly become 

 inflated under manual movements. If the solution is thrown 

 ■out, the vagina may collapse and closely invest the hand, in 

 -which case more of the liquid should be injected when it 

 ■will again dilate. If the hand is introduced without the 

 knife, withdrawn, and then introduced with it, it will be 

 frequently found that the vagina has collapsed and needs a 

 second filling with the fluid. Patience until dilation is 

 accomplished and promptness to act when attained are prime 

 requisites to success. 



