when it is found outside of the uterine

cavity.

V. Abdominal section for rupture of the uterus.

Operations on the Stomach and Intestines:

I. Gastrotomy-the making of an incision into
the stomach for the removal of foreign
bodies.

II. Gastrostomy-the establishing of a tube-like
passage into the stomach.

III. Gastrorraphy-the suturing of wounds in the stomach.

IV. Pylorectomy-removal of a part or the whole of the pylorus.

V. Gastro-enterostomy-the formation of a pas

Operations on the

stomach.

sage between the stomach and duodenum. VI. Duodenostomy-the operation of opening the Operations duodenum, and attaching it to the abdom- tines.

inal wall to form an orifice for the intro-
duction of food.

VII. Jejunostomy-the making of an artificial
opening through the abdominal wall into.
the jejunum, for introduction of food.

VIII. Operation for intestinal obstruction.

IX. Enterotomy-the making of an opening into the intestine.

X. Colotomy-the making of an incision into. the colon.

on intes

XI. Resection of intestine-the removal of a

portion of intestine.

XII. Operation for artificial anus.

Operations Operations on Kidneys :—

on kidneys.

on

and gallbladder.

I. Nephrorrhaphy-the suturing of the kidney
to the abdominal wall.

II. Nephro-lithotomy-the operation for removal
of stone in the kidney.

III. Puncture of the kidney.

IV. Nephrotomy-an operation for opening into̟
the substance of the kidney.

V. Nephrectomy-removal of the kidney.

Operations Operations on the Liver and Gall-Bladder:—
I. Hepatotomy—an operation for opening into
the liver.

II. Cholecystotomy-an operation for opening
into the gall-bladder.

III. Entero cholecystotomy - an

operation in

which, after opening into the gall-bladder
and intestines, the two wounds are sutured
to each other.

IV. Cholecystectomy-removal of the gall-blad

der.

Operations Operations on the Spleen :

on spleen.

Splenectomy-removal of the spleen.

Operations on the Pancreas :

Operation for pancreatic cysts.

Operations on pancreas.

Operations

on omentum and mesentery.

Operations for Tumors of the Omentum. Operations for Tumors of the Mesentery. Cystotomy, or abdominal lithotomy-an operation Operations for an incision through the abdominal wall into the bladder.

Although the operations mentioned are numerous, the general preparations for any case of abdominal section are so similar that they can be considered under one head. These will include the consideration of the following points:

I. Preparation of the room.

II. Preparation of sponges, instruments and dressings.

III. Preparation of the patient.

IV. Preparation of the operator and assistants.
V. A nurse's duty during operation.

VI. A nurse's duty after operation and during
convalescence.

VII. The management of complications.

on bladder.

The operat

ing room.

CHAPTER V.

THE PREPARATION OF THE ROOM.

In speaking of the importance of obtaining for the patient the best possible surroundings for such an operation a celebrated English surgeon says: "There is no disputing the fact that the best results in abdominal surgery are got in specially prepared rooms or wards. * * * * An ideal room, situated in an open and elevated locality, ventilated with warmed (and perhaps filtered) air, wall and floor impermeable to moisture, and readily and easily washed, and with many other excellences which could be detailed- is rarely in this country at the disposal of surgeons."

As a rule, the operation is done in the room which is to be occupied by the patient during the convalescence, unless in a special hospital where the rooms are conveniently arranged with reference to an operating room, and where suitable conveniences exist for transferring patients from one room to another without too great risk.

All the special preparations for aseptic work may be carefully arranged for, yet these cannot secure

the results desired, should the operator, assistants, or nurses fail to observe the principles of surgical cleanliness in every detail. On the other hand, with a thorough understanding of these principles, operations of the gravest character may be performed with success in quarters the most unpromising, and in the slums and alleys of a crowded city. Since "necessity knows no law," the surgical nurse must be prepared to convert even the filthy apartment of a tenement house into an aseptic operating To this end certain instructions regarding the preparation of the room should be observed.

room.

Cleansing of

Dr. J. Grieg Smith tells us, "A well kept bedroom in a home of gentle folks will require nothing changed or removed." Should the surgeon in charge of a case assume the responsibility of this arrangement, the nurse will, of course, observe his wishes in the matter. Should the preparation of the room be left to her discretion, she should re- room. gard everything in the room with suspicion until she has placed it beyond suspicion in the matter of cleanliness. The room should, if possible, be large and bright, facing the south, and one which can be kept well ventilated and yet comfortably warmed. There should be no stationary wash-stand in the room. If impossible to obtain a room without, the basin should have all its outlets plugged, and be kept filled with some antiseptic solution.