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July 2, 1887


JAMA. 1887;IX(1):29. doi:10.1001/jama.1887.04360030028010

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Dear Sir:—In the letter of Dr. N. Senn, published in The Journal of June 4, there occur on page 641, in reference to an ovariotomy by Mr. Langton, the following remarks: "The abdomen was opened by an incision through the linea alba about four inches in length, and the cyst tapped with the large trocar of Spencer Wells. The puncture was followed by a free escape of fluid along the sides of the trocar, and some of it entered the abdominal cavity, and the wound was freely irrigated with the cyst contents..... It has always seemed to me that the use of a large trocar with a truncated cutting edge in lapping a tense cyst is attended invariably by extravasation of fluid, and consequently increases the risk of peritonitis. When the cyst contents are fluid, the patient should either be placed upon her side during the tapping, and proper

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