1 30 O VARIO TOMY IN THE BITCH. 



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 the 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 necessary 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 preceeds in 

 the same manner as by the flank method. By passing an 

 index finger forward to reach the lower surface of the rec- 

 tum in front of the uterus and then drawing it backwards 

 the finger passes between the former and the cornua and 

 the latter is picked up. It 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 cornua and the ovary being retained. By 

 the use of retractors in the abdominal incision the operator 

 is enabled to see the uterus in position and grasp it by 

 means of forceps, obviating the necessity for introducing 

 the finger into the peritoneal cavit3^ The sutures must 

 extend entirely through the abdominal wall and be carefully 

 placed in order to prevent hernia. Interrupted sutures are 

 preferable. If the operation has been properly performed 

 no bandage is necessary and the patient will not disturb the 

 sutures. If asepsis has not been strictly followed infec- 

 tion may occur and the consequent irritation cause the 

 patient to tear the sutures out, which may lead to protrusion 

 of the intestines or other abdominal viscera. If the sutures 

 do not include the deeper layers of the abdominal wall 

 hernia is liable to occur and require a second operation. \ 



