Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . s for spleen; L,median midabdominal; M, infraumbilical midabdominal; N, vertical median suprapubic;O, suprapubic transverse curved. The costal arch in this picture should be just abovethe lines A and / as these incisions are to be placed just below and parallel with the costalborder. The peritoneum should not be mistaken for intestine. If intestine iswounded, it should at once receive the neeessary attention (page 628).Extraperitoneal connective tissue should not
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Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . s for spleen; L, median midabdominal; M, infraumbilical midabdominal; N, vertical median suprapubic;O, suprapubic transverse curved. The costal arch in this picture should be just abovethe lines A and / as these incisions are to be placed just below and parallel with the costalborder. The peritoneum should not be mistaken for intestine. If intestine iswounded, it should at once receive the neeessary attention (page 628).Extraperitoneal connective tissue should not be confused with omentum.The peritoneum is opened by picking it up with two pairs of forceps, to holdit away from the viscera, and making a small opening between (Fig. 1181).The two edges of the wound are held open by forceps, a finger or other pro- 506 6 iRGl CA L TREA TMEN T tector slid beneath the peritoneum, and the opening enlarged with scissors tothe desired extent. Before opening the peritoneum all bleeding should havebeen controlled and clamps removed. There are no vessles of consequencein the anterior abdominal wall.. Fig. iiSo.—Postmuscular Median Incision. Showing path of entrance to abdomen. The rectus is retracted outward as soon as it is exposed by the anterior incision.