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After the gas has escaped through the cannula, the trocar is replaced and the instrument withdrawn. After using the trocar and cannula, the instrument should be cleaned by placing it in boiling hot water. It is advisable to wash the skin at the seat of the operation with a disinfectant before operating.
Finally, there are cases in which removal by operation is impossible, the so-called inoperable sarcoma; a tube of radium, to which a silk thread is attached, is inserted into the substance of the tumour, either through an opening made by a large trocar, or, when necessary, by open dissection.
On Sunday the vessel dropped down to Gravesend, where, on the next day, Mr. Welch, who until then had attended them, took his leave; and, Fielding, relieved by the trocar of any immediate apprehensions of discomfort, might, in spite of his forlorn case, have been fairly at ease. He had a new concern, however, in the state of Mrs.
Under such conditions the tension should be relieved and the exudate with its contained toxins removed by making an incision into the inflamed tissues, and applying a suction bell. When the exudate has collected in a synovial cavity, such as a joint or bursa, it may be withdrawn by means of a trocar and cannula.
Upon opening the sac with the trocar we were confronted by complications entirely unlooked for, and its use had to be abandoned entirely because the thick contents of the cyst would not flow freely, and the presence of sebaceous matter blocked the instrument. As much of the fluid as possible was removed, and the abdominal incision was enlarged to allow of the removal of the large tumor.
The gaseous disturbances should be relieved by puncturing the wall of the intestine with the trocar and cannula. Rectal injections of cold water may be resorted to. Fluid extract of cannabis indica in quarter ounce doses and repeated in one hour may be given in linseed oil. In all cases it is advisable to drench the animal with one pint of raw linseed oil and two ounces of turpentine.
The introduction of a sterile instrument into a joint cavity, under strict asepsis, where a perfect technic is executed, does not cause perceptible manifestation of the injury, if the opening so made is small such as a suitable exploratory trocar makes.
"These were what I needed," he continued, with a low chuckle; "I could not attain the goal without these beauties." Caressingly he went over them. "Lancet, probe, trocar, bistoury, tourniquet," mentioning the collection, while he passed his fingers affectionately along the small sharp knives. "For years and years," he went on, "I have studied this theory.
No difficulty is encountered in recognizing these conditions even where considerable organization of tissue overlying distended thecae occurs. In such cases there may be only slight fluctuation of the enlargement, but if necessary, an aseptic exploratory puncture may be made with a suitable needle or trocar. Treatment.
In such instances the exterior of the wound and its margins should be prepared as in similar affections of other joints. A quantity of synovia is then aspirated by means of a small trocar and care should be taken to observe all due aseptic precautions.
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