OVARIOTOMY IN THE BITCH 119 



Uterus according to its degree of distension. When empty 

 as shown at B, it offers practically no obstruction. When 

 very much distended, it may be evacuated by gentle pressure 

 with the fingers. The operator should be careful not to 

 draw the bladder out through the incision as its replace- 

 ment may prove difficult and its puncture with a hypo- 

 dermic needle or an enlargement of the abdominal incision 

 may be necessary in order to bring about its return. Push 

 the bladder aside if nedessary and just above it and below the 

 rectum, the uterus should be readily distinguished and either 

 it or the broad ligament caught by the finger and brought 

 out through the incision, after which the operation proceeds 

 in the same manner as by the flank method; By passing 

 an index finger forward to reach, the lower surface of the 

 rectum, in front ot the uterus- and. tlieit drawing it back- 

 ward., the fing^er passes betweea the former and the cornua 

 and the latter are picked up. This operation- has a distinct- 

 advantage over the flank method in that in puppies there is 

 not so much difficulty in bringing out the ovaries, nor the 

 danger of the rupture of the cornu and the ovary's being 

 retained. 



By the use of retractors in the abdominal incision, the 

 operator is enabled to see every part of the uterus, grasp it 

 by means of forceps, and perform all intra-abdominal por- 

 tions of the operation with instruments and avoid the ne- 

 cessity for introducing the finger into the peritoneal cavity. 



The sutures must extend entirely through the abdominal 

 wall and be carefully placed in order to prevent hernia. 

 The sutures should be in laminae, the peritoneal of 

 catgut, that in the linea alba of slow dissolving cat- 

 gut, and those in the skin, of silk or linen. These 

 latter may extend down into the linea alba and include 

 the wound in that structure in a second suture. 

 Interrupted sutures are preferable. If the operation 

 has been properly performed, no bandage is neces- 



