The dissection plastic

The dissection plastic

The latter tend to damage the epithelial lining of the tube; streptococci create a perisalpingitis and adhesions which interfere with the motility of the tube, which is essential to physiological transport of the ova into the uterine cavity. Other intra-abdominal infections resulting in pelvic peritonitis would create similar problems. Perisalpingitis is quite common following acute appendicitis or an appendiceal abscess.

When the hysterosalpingogram indicates that there is normal patency of the tubes and lesions are seen on culdoscopy, it is reasonable to assume that they are interfering with tubal motility. It is possible to correct this condition by freeing the adhesions.

Figure 1. A traction suture is placed in the fundus of the uterus, which is held on tension and drawn toward the operator’s side of the table. The open fimbriated ends of the tube lie on the surface of the ovary, but it is apparent that the mesosalpinx is foreshortened because of adhesions binding the tube to the surface of the ovary.

Figure 2. Continuing the traction on the uterus the surgeon and assistant gently hold the tube on tension with blunt-end, smooth forceps as the surgeon gently divides the adhesions with fine dissecting scissors of the Metzenbaum type.

Figure 3. After the adhesions have been separated the mesosalpinx comes into view and the open end of the tube lies free. The motility of the tube is restored.

The dissection plastic (Higher Surgical Training):

THE DISSECTION PLASTIC

THE DISSECTION PLASTIC

THE DISSECTION PLASTIC

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