Instruments for Section 599 



into it, by maintaining a steady pressure in the opposite direction 

 and then being ready, as soon as the expulsive efforts relax, to 

 quickly accomplish the results which are desired. 



Instruments for Section. 



Traction and repulsion, with any accompanying changes in 

 the position of the fetus, cannot always bring about a sufficiently 

 favorable position of the fetus or other essential conditions to al- 

 low of its extraction whole. Consequently the operator is fre- 

 quently compelled to diminish the size of the fetus by removing 

 one or more parts so as to permit of its easy passage through the 

 birth canal. For the carrying out of embryotomy, a greater 

 variety of instruments has been devised than for any other 

 obstetric purpose. 



Each operator has his own preference in the selection of his 

 means for bringing about these ends, and for each operator those 

 instruments to which he is accustomed may be the best because 

 there is no place in the realm of surgery where familiarity with 

 an instrument constitutes so great a part of its value to the oper- 

 ator as in embryotomy. 



Knives. First and most important in this group of instru- 

 ments are the knives, of which we have an infinite variety offered 

 by the various instrument makers. We may divide these into 

 two great cla.sses ; the finger-knife, and the short-handled knife or 

 scalpel. 



The finger-knife, Fig. 95, which is attached to one of the 

 fingers by means of one or two rings, is one of the simplest and 

 most effective of all embryotomy section instruments, and is per- 

 haps the most universally u.sed. It is made in various shapes, 

 according to the individual preferences of the operator. Most fre- 

 quently it consists of a somewhat narrow blade which is curved 

 downward. The blade may advantageously be hooked for all 

 tho.se operations where it is desired to make a long, drawing cut, 

 by inserting the hand to the point where we wish the incision to 

 begin and then making the cut as the hand is drawn outward. 

 In such a case the hooked knife .sinks into the tissues automa- 

 tically and the operator simply keeps his hand against the surface 

 which he wishes to cut and draws it outward. 



Finger knives, as made by most instrument dealers, are toa 

 long for the average operator and cannot be easily handled. The 



