296 VETERINARY SURGICAL OPERATIONS 



TECHNIQUE. — First Step.— Location of the Incision.— 



The left side is now most frequently selected for the lapar- 

 otomy, although either will answer. On the left side there is 

 only the rumen while on the right one there is a mass of 

 bowels with which to cope. The incision is made perpen- 

 dicularly in the very middle of the space between the external 

 angle of the ilium and the last rib, and extends from a 

 point about two inches from the transverse processes of the 

 lumbar vertebras downwards three and one-half to four 

 inches, according to the size of the surgeon's hands. The 

 author prefers the vertical incision, but others favor a slightly 

 diagonal one extending downward and forward. (Fig. 147.) 



Second Step. — The Laparotomy. — The thick skin is cut 

 through at one firm, deliberate stroke, (three and one half 

 to four inches) exposing at once the underlying external 

 oblique muscle, whose fibers extend downward and back- 

 ward. The division of this muscle is made in the direction 

 of "its fibers with the scalpel, and then the incision is -torn 

 wider with the fingers, exposing the internal oblique, which 

 is then treated in the same manner ; that is to say, it is in- 

 cised in the direction of its fibers. The underlying aponeu- 

 rosis and the peritoneum is punctured with the point of 

 the scalpel and then enlarged by tearing. At once the in- 

 ward suction of air announces that the abdominal incision 

 is complete. The rumen is now in view. The object of mak- 

 ing this apparently complicated abdominal incision is to 

 create an automatically closed opening. The incisions 

 through the muscles cross each other in such manner as to 

 effect an almost perfect closure, and the time required to 

 make them is no greater than a direct through and through 

 division of the entire wall. 



Third Step. — The Search for the Ovaries. — The surgeon 

 stands with his back to the patient's head, passes the left 

 hand through the incision, backward and downward over the 

 rumen and then across the abdominal cavity to the point 

 where the brim of the pubis turns upward toward the shaft 

 of the ilium. It is in this region that the right ovary is 

 found hanging from its appendages. It is recognized by its 

 hanging position, by the facility with which it can be moved 

 about in every direction, by its undulated surface due to 

 the maturing Graffian vesicles, and by its size. The ovaries 

 of hiefers are about the size of the end of a man's thumb, of 

 an acorn, of an almond nut, or of a small hickory nut. The 

 only other structures with which they may be confounded are 



