In describing the ventral suspension operation for retroversion such as the Gilliam, Olshausen or the Graves modification of the latter, Graves,1 Crossan2 and Miller3 all call attention to the danger of intestinal obstruction from internal herniation following this type of suspension but feel that the occurrence of this sequel is exaggerated. In the original Gilliam operation the round ligaments are brought by a perforating clamp through the peritoneum, muscle and fascia and fastened to the outer side of the fascia. In the Simpson modification of the Gilliam operation the round ligaments are brought through the peritoneum to the internal ring and make intestinal complications less likely. In either the Gilliam or the Olshausen operation there is created a potential hernial ring between the point of attachment of the round ligament to the peritoneum and its exit by way of the internal ring to the inguinal canal. Under
MICHAEL MA. INTERNAL HERNIA FOLLOWING ROUND LIGAMENT SUSPENSION: REPORT OF TWO CASES. JAMA. 1936;107(16):1293–1294. doi:10.1001/jama.1936.02770420031009
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