RESECTION, ABLATION, AMPUTATION 



33 



terfering with the progress of the dissection, the flow may be 

 effectually limited by touching each bleeding spot with the 

 thermo-cautery in the hands of the third assistant. The 

 value of the thermo-cautery in this connection is immense. 

 Often an exceptionally extensive dissection can thus be com- 

 pleted with an incredibly small loss of blood. 



In making dissections, the surgeon must always "know 

 his ground," in order to avoid transgression upon forbidden 

 structures. The division of a large vessel, motor nerve 

 trunk, or important tendon, or the incision of a synovial sac, 

 or one of the splanchnic cavities, are among the many possi- 

 ble accidents of a careless dissection. 



Resection, Ablation, Amputation. 



DEFINITIONS.— In the literal sense these three words 

 are synonymous, meaning the removal of a part of the body. 



Fig. 19 — The Scalpel and Forceps in Dissection. 



In surgery, however, each one is reserved to designate a 

 special process. Resection is the removal of a part of a 

 structure or organ, such as a part of a nerve, tendon, muscle 

 or any tissue. Ablation at once suggests the removal of an 

 entire structure or organ, such as a tumor, a scirrhous cord, 

 the testicles, the thyroid body, etc. Amputation refers only 

 to the removal of all or part of a projecting anatomical 

 member of the body, such as the tail, an extremity, the 

 tongue, the ears, etc. A nerve is resected, a tumor is ablated, 

 and an extremity is amputated. 



INDICATIONS. — In surgical operations the process 

 called resection is indicated both on normal and diseased 

 structures. A resection of normal tissues may be necessary 

 to make a path to remote structures which are the real ob- 

 jects of attack ; to establish drainage orifices or other arti- 

 ficial communications; to effectually destroy the continuity 



