1907 BJOG: an International Journal of Obstetrics and Gynaecology  
Mr. ALBAN DORAN read notes of a case where, in July, 1901, he removed a cystic tumour of the left ovary and a fibroma of the left broad ligament. After enucleation of the solid tumour he turned the pedicle of the ovarian cyst into the space between the layers of the broad ligament, which he then sewed over it. I n January, 1906, Mr. Doran removed a cystic tumour of the same right ovary, which was of a perfectly innocent type. There were no adhesions on the left side of the uterus, a fact which
more » ... eemed to demonstrate the advantages of the treatment of the pedicle adopted a t the first operation. The PRESIDENT said that he agreed that it was desirable, when possible, to bury pedicles in the broad ligament ; but thatwas not always practicable. The rate of disappearance of silk varied much in different cases. He had seen the silk completely disappear from ovarian pedicles in three months, leaving the stump a t the cornu of the uterus smooth and quite free from adhesions. On the other hand, he had found silk present after seven years. Dr. LEWERS said that he had performed abdominal section a second time in the same patient in a considerable number of cases. It was certainly not the case, that the pedicle left after removing an ovarian tumour, treated in the ordinary way, invariably contracted adhesions. He had several times seen it quite free from such adhesions. Dr. PETER HORROCES said he had several times seen cases where there were no adhesions over the stump after an operation performed a considerable time previously. He mentioned a recent case where the ovaries had been removed nine years before, on account of a fibroid tumour. The latter, however, began to grow and give trouble, and s o was removed a week ago by panhysterectomy. No adhesions were found over the stumps of the old operation. He remembered other cases illustrating the same fact, and he was inclined to think that the greater the degree of asepsis the less likelihood there is of adhesions forming over the stump. He also thought that if the distal end was strangulated by the ligature being very tight, adhesions were apt to form. Mr. ALBAN DORAN maintained that the usual practice of leaving a ligatured pedicle bare in the peritoneum often led to extensive, if not dangerous, adhesions. Such was his experience of second ovariotomies on the same patients. Twenty years ago, when thick silks were applied to thick pedicles and the peritoneum irritated by sponges, this complication The right ovary was noted as small and normal.
doi:10.1111/j.1471-0528.1907.tb11754.x fatcat:wmoslvwawvfq7jmr2y4lh5f2hm