686 
DEPARTMENT OF SURGERY 
ditions revealed when the operation (Caesarian) is performed. 
When the uterus or its appendages are injured or diseased, they 
should be removed. The removal of the uterus as a sequel of 
Caesarian section was first done in human surgery in 1876 by i 
Porro, and since has been known as Porro’s operation. The 
operation maybe described as Caesarian section with the removal 
of the uterus at the cervix, along with all its appendages. 
Parietal Incision is the same as in Caesarian section, except 
that it should be made a little longer and nearer to the median 
line, especially when the whole uterus is brought out of the ab¬ 
dominal cavity before incising it. The advantages of this 
method are, that it avoids the danger of uterine fluids escaping 
into the peritoneal cavity ; this alone is very advantageous when 
the foetus is dead and the uterus filled with putrid fluids; by 1 
this method of handling the uterus, it makes it easier to arrest 
haemorrhage ; but this method, however, has not met the ap¬ 
proval of all surgeons ; it has been greatly modified, and in most 
instances is incised and emptied before removing it. 
Incision Into the Uterus may be made in most any direction ; 
if the uterus is to be amputated it can be incised longitudinally, 
transversely, or both, as the case may require. The site of the 
incision should be selected, limited and directed by the location 
of blood vessels ; the incision made as rapidly as possible, either 
with a pair of scissors or by tearing; but before doing this 
tampons or sponges must be placed around the uterus in such a 
manner that they will prevent the fluids entering the cavity. 
When the uterus is incised, the surgeon should remove the 
foetus and give it to some attendant and then direct his atten- 
FIG. 
I. 
