author - "Joseph Bell"
ntly proved that the circulation can be carried on, and gangrene does not necessarily result even after such a decided interference with vascular supply.
Operation.--The ligature may be applied in one of two ways, the choice being influenced by the nature of the disease for which it is done.
1. A straight incision (Plate I. fig. 1) in the linea alba, just avoiding the umbilicus by a curve, and dividing the peritoneum, allows the intestines to be pushed aside, and the aorta exposed still covered by the peritoneum, as it lies in front of the lumbar vertebræ. The peritoneum must again be divided very cautiously at the point selected, and the aortic plexus of nerves carefully dissected off, in order that they may not be interfered with by the ligature. The ligature should then be passed round, tied, cut short, and the wound accurately sewed up.
2. Without wounding the peritoneum.
A curved incision (Plate I. fig. 2), with its convexity backwards, from the projecting end o
ntly proved that the circulation can be carried on, and gangrene does not necessarily result even after such a decided interference with vascular supply.
Operation.--The ligature may be applied in one of two ways, the choice being influenced by the nature of the disease for which it is done.
1. A straight incision (Plate I. fig. 1) in the linea alba, just avoiding the umbilicus by a curve, and dividing the peritoneum, allows the intestines to be pushed aside, and the aorta exposed still covered by the peritoneum, as it lies in front of the lumbar vertebræ. The peritoneum must again be divided very cautiously at the point selected, and the aortic plexus of nerves carefully dissected off, in order that they may not be interfered with by the ligature. The ligature should then be passed round, tied, cut short, and the wound accurately sewed up.
2. Without wounding the peritoneum.
A curved incision (Plate I. fig. 2), with its convexity backwards, from the projecting end o