Seymour J. Sharkey, H. H. Clutton
1892 American Journal of the Medical Sciences  
present day, os a rule almost without exception, be performed at the same sitting. The patient has a right to expect this from the expert claiming to possess the highest degree of operative skill. That this will be the standard of the near future the author does not doubt. Success in combined gynecological operations presupposes first of all perfect asepsis and a not too prolonged amesthesia. The duration of the latter need but very rarely exceed one and a half hours even in the most difficult
more » ... the most difficult cases. Other things necessary are the requisite degree of operative skill and dexterity, sufficient and efficient assistance, a perfected technique of the various operations attempted, and an instrumentarium suitable for rapid work. Combined gynecological operations may be divided into two general classes: 1. Combinations into which a laparotomy does not enter. 2. Combinations of which a laparotomy forms part The expert operator should be able to perform any required com¬ bination of operations of the first class within the time-limits of safe anaesthesia. The same statement holds good of the combinations of operations of the second class into which a simple laparotomy enters. When a difficult laparotomy forms part of the combination the patient's interests may occasionally be better served by operating at two sittings. There is no excuse for a mortality in combined operations of the first class. The mortality of combinations into which a laparotomy enters will depend upon that of the special intra-abdominal operative inter¬ ference required. He was one of a very stalwart, healthy family, the father, aged eightv-five years, and mother being still alive and well, in addition to nine brothers and three sisters. The patient had not fallen short of the high standard of health which was so marked a characteristic of his family; he had never been ill since childhood, but he had had for ten years a " rupture " on the right side.
doi:10.1097/00000441-189210430-00004 fatcat:oqwq6dto4fcdjpph36ucyjicum