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    none: Fig. 2. Coupe horizontale au niveau des reins (schématique) / Fig. 3. 1, Lame rétro-rénale. - 2. Lame pré-rénale. - 3. Péritoine. - c. Coupe de côlon
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    none: Fig. 4. 1. Lame rétro-rénale. - 2. Lame pré-rénale. - 3. Péritoine pariétal primitif. - c. Côlon après application sur le rein gauche. - 4. Mésentère primitif
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    none: Fig. 5. Anomalie de la veine rénale gauche
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    none: Fig. 6. 1-1. Rameau propre du rein. - 2-2. Anastomose transversale. - 3. Segment de la cardinale gauche qui contribuera à former la rénale gauche anormale. - 4. Future iliaque primitive gauche
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    none: Fig. 8. R, paroi antérieure du rectum très oblique en haut et en avant, doublée du muscle recto-uréthral - r.r', surfaces de section du raphé périnéal. - m.r.a, muscle releveur de l'anus
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    none: Fig. 9. Tracé du volet thoracique dans l'oesophago-gastrostomie
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    none: Fig. 10. L'oesophage est basculé, de façon à permettre l'isolement des filets nerveux / Fig. 11. Le diaphragme a été incisé. Immédiatement se présente la grosse tubérosité de l'estomac, flanquée du foie et de la rate
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    none: Fig. 21. Tracé de l'incision cutanée / Fig. 22. Le cône gastrique est attiré au dehors
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    none: Fig. 23. L'estomac est fixé à la gaine postérieure du droit / Fig. 24. On se prépare à transfixer la séro-musculeuse de l'estomac
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    none: Fig. 25. La séro-musculeuse s'est rétractée après incision et, avec un fin bistouri, on fait à la muqueuse une ouverture aussi petite que possible / Fig. 26. L'opération est terminée
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    none: Fig. 27. Tracé de l'incision cutanée
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    none: 0031 - Page 33
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    none: Fig. 28. Dissociation du grand oblique / Fig. 29. Dissociation du petit oblique et du transverse
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    none: Fig. 30. Mise en place de l'écarteur / Fig. 31. Ligature du méso-appendice / Fig. 32. Mise en place du surjet en bourse
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    none: 0033 - Page 35
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    none: Fig. 33. Ligature de l'appendice à sa base / Fig. 34. Mise en place d'une pince de Kocher destinée à empêcher, après section de l'appendice, l'issue du liquide contenu dans sa cavité / Fig. 35. L'appendice est enlevé / Fig. 36. L'aide refoule, avec une sonde cannelée, le moignon appendiculaire dans un pli de la paroi caecale
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    none: Fig. 37. Opération terminée
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    none: 0035 - Page 37
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    none: Fig. 38. Aspect des lésions dans un cas de fistule jéjuno-colique
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    none: Fig. 39. Après séparation de l'anse descendante et du côlon transverse, on aperçoit la double perforation produite par l'ulcère
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    none: Fig. 40. L'orifice jéjunal et l'orifice du côlon ont été suturés
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    none: Fig. 41. Appendicectomie à travers le sac
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    none: Fig. 42. L'ablation de l'appendice est impossible par l'orifice abdominal du sac ; on se résout à la dissociation musculaire
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    none: Fig. 43. On a abandonné momentanément la cure de la hernie et on pratique l'appendicectomie après dissociation musculaire
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    none: Fig. 44. La brèche musculaire a été suturée et la cure de la hernie est achevée
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    none: Fig. 45. Coupe longitudinale et verticale du néoplasme
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    none: Fig. 46. A droite, glande pylorique dont les cellules se transforment peu à peu en cellules de type intestinal
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    none: Fig. 47. Villosités cancéreuses végétant dans une cavité remplie de leucocytes
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    none: Fig. 48. L'estomac a été ouvert sur sa face antérieure. Insérée sur la petite courbure et sur la face postérieure, apparaît une volumineuse tumeur mamelonnée
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    none: Fig. 49. Aspect de la tumeur coupée suivant son grand axe
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    none: Fig. 50. Cholédocotomie duodénale. Opération de Mac Burney / Fig. 51. Opération de Kocher. Après duodénotomie transversale, on incise la paroi postérieure du duodénum / Fig. 52. Second temps de l'opération de Kocher. Le cholédoque est ouvert, après section de la paroi postérieure du duodénum, et le calcul est mis à nu / Fig. 53. Dernier temps de l'opération de Kocher : anastomose latérale du cholédoque et du duodénum
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    none: Fig. 54. Opération de Collins
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    none: Fig. 56. Cancer de l'hépatique. Vésicule non dilatée / Fig. 57. Cancer du confluent. La vésicule est dilatée, mais ne contient pas de bile / Fig. 58. Cancer cholédoque. - Grosse vésicule / Fig. 59. Cancer de l'ampoule. Voies biliaires dilatées. Grosse vésicule
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    none: Fig. 60. Une forte traction exercée sur la vésicule et le cystique met en relief le chodéloque et permet d'en pratiquer l'ouverture
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    none: Fig. 61. Manière d'explorer le chodéloque
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    none: Fig. 62. L'opération est terminée. Un drain est placé dans l'hépatique et la plaie du canal est rétrécie par des points au catgut
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    none: Fig. 63. Disposition normale de l'artère cystique qui se détache de la branche droite de l'artère hépatique avant sa pénétration dans le hile et qui longue de 1 centimètre, fort grêle, aborde le flanc gauche de la vésicule à 2 centimètres de l'origine du cystique (à noter la disposition fort intéressante du canal cystique, s'ouvrant sur le bord gauche du canal hépatique dont il croise la face postérieure) / Fig. 64. L'artère cystique se détache de la grosse branche droite de l'artère hépatique au point où cette dernière se bifurque / Fig. 65. De la branche droite de l'artère hépatique naissent par un tronc très court deux branches cystiques (à noter les rapports de la branche inférieure avec le canal cystique)
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    none: Fig. 66. Des deux branches de l'artère hépatique droite bifurquée en une branche suivant le bord gauche du canal hépatique et une branche croisant la face postérieure de ce canal naissent deux artères cystiques / Fig. 67. L'artère hépatique donne quatre branches dont trois destinées au foie et une gastro-duodénale / Fig. 68. L'artère cystique se détache de l'artère gastro-duodénale qui continue directement l'artère hépatique
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    none: Fig. 69. Artère cystique naissant de l'artère gastro-duodénale longue de 3 centimètres et assez volumineuse
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    none: Fig. 70. Aspect des voies biliaires après libération de la face inférieure de la vésicule
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    none: Fig. 71. La partie toute terminale du cystique, bien souvent saine, a été isolée et dénudée à la manière d'une artère
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    none: Fig. 72. Le cystique est libéré d'arrière en avant et, par cette manoeuvre, on tend le pédicule vasculaire qu'il est alors facile de lier
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    none: Fig. 75. Cholécystectomie d'arrière en avant. Ligature d'une artère cystique unique / Fig. 74. Cholécystectomie d'arrière en avant. Ligature d'artères cystiques doubles
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    none: Fig. 75. Après section première du cystique, la vésicule, tenue dans la main gauche du chirurgien, est décollée d'arrière en avant grâce à l'index qui travaille entre la face profonde de la vésicule et la surface hépatique
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    none: Fig. 76. La cholécystectomie d'arrière en avant n'a pas été possible ; force a été d'attaquer la vésicule par son fond et de la libérer d'avant en arrière
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    none: Fig. 77. La cholécystectomie est terminée et la suture du péritoine de la vésicule permet d'établir un drainage sous-séreux
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    none: Fig. 78. La cholécystectomie est achevée et la suture du péritoine permettra d'enfouir le moignon du cystique et de se passer de tout drainage
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    none: Fig. 79. Après décollement duodéno-pancréatique, la main gauche du chirurgien extériorise et immobilise la deuxième portion du duodénum
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    none: Fig. 80. La papille est incisée verticalement, ce qui est presque toujours nécessaire pour extraire le calcul
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    none: Fig. 81. Suture du duodénum au moyen d'un surjet total et d'un surjet séro-séreux
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    none: Fig. 82. Longue incision courbe lombo-abdominale
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    none: Fig. 83. Suture de la lèvre postérieure / Fig. 84. Opération terminée. Sonde à demeure
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    none: Fig. 85. Tracé de l'incision cutanée
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    none: Fig. 86. Le décollement du rectum est achevé / Fig. 87. Le releveur a été échancré à droite et à gauche pour donner du jour
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    none: Fig. 88. Tracé de la partie interne de l'incision cutanée ; - isolement et section du muscle grand pectoral
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    none: Fig. 90. Les deux muscles pectoraux ont été rabattus. On aperçoit le paquet vasculo-nerveux et les ganglions
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    none: Fig. 91. Les rameaux de l'artère axillaire et de la veine ont été liés au voisinage des gros troncs et le contenu de l'aisselle est libéré de haut en bas / Fig. 92. Le nerf du grand dorsal et le nerf du grand dentelé ont été respectés
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    none: 0095 - Page 97
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  label:
    none: Description
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    none: Fig. 93. L'ablation du sein est presque achevée / Fig. 94. Suture cutanée. Drainage à travers le lambeau postérieur
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    none: 0096 - Page 98
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    none: Fig. 95. Un débridement cutané sus-claviculaire permet de mettre à nu la clavicule et d'en préparer la section
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    none: Fig. 96. La clavicule est sectionnée. On peut disséquer les ganglions sus-claviculaires
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    none: Fig. 97. Tumeur de la trompe gauche / Fig. 98. Coupe longitudinale de la tumeur
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    none: 0100 - Page 102
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    none: Fig. 99. Mise en place des écarteurs
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    none: ark:/13685/110133x105x03/0100
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    none: 0101 - Page 103
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    none: Fig. 100. Disposition des compresses qui limitent le foyer opératoire
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    none: ark:/13685/110133x105x03/0101
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    none: 0102 - Page 104
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    none: Fig. 101. Section du pédicule utéro-ovarien
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    none: ark:/13685/110133x105x03/0102
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    none: Fig. 102. Section du ligament rond et de la portion moyenne, avasculaire, du ligament large
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    none: ark:/13685/110133x105x03/0103
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    none: Fig. 103. On a sectionné et lié de chaque côté le ligament utéro-ovarien et le ligament rond. On va pratiquer le tracé de la collerette péritonéale
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    none: Fig. 104. Décollement de la vessie. Section des artères utérines
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    none: ark:/13685/110133x105x03/0105
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    none: 0106 - Page 108
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    none: Fig. 105. Ouverture du cul-de-sac antérieur du vagin
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    none: ark:/13685/110133x105x03/0106
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    none: Fig. 106. Le vagin a été sectionné sur la ligne médiane postérieure jusqu'au fond du Douglas
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    none: Fig. 107. Surjet unissant l'S iliaque et le péritoine vésical
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    none: ark:/13685/110133x105x03/0108
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    none: 0113 - Page 115 - Travaux scientifiques. Chapitre V. Chirurgie de guerre
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    none: Fig. 108. Position du bras en extension forcée avec adduction et rotation interne, en même temps que flexion de l'avant-bras
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    none: Fig. 109. La ligne représentée par des croix marque l'interstice de la longue portion et du vaste externe / Fig. 110. Le paquet vasculo-nerveux (nerf radial et artère humérale profonde) est mis à découvert
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    none: Fig. 111. La longue portion du triceps reportée en dehors pour la découverte de l'origine du nerf radial / Fig. 112. Le nerf radial s'engageait sous un pont osseux
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    none: Fig. 113. Après destruction du pont osseux, on aperçoit le nerf radial, beaucoup plus grêle que normalement / Fig. 114. L'opération est terminée et on a eu soin d'interposer quelques fibres musculaires entre le nerf radial et la surface osseuse
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    none: Fig. 115. Section complète du radial ; restauration tonique, puis motrice des muscles après suture du nerf (d'après Mme Dejerine)
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    none: Fig. 116. Disposition anatomique des ganglions inguinaux
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    none: Fig. 117. Incision parallèle à l'arcade. Indiquée dans le cas d'adénites inguinales et d'adénites iliaques
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    none: Fig. 118. La veine saphène interne est dénudée à la partie inférieure de l'incision cutanée, au-dessous des ganglions les plus inférieurs
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    none: Fig. 119. Section et ligature de la saphène interne
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    none: Fig. 120. Les masses ganglionnaires, appendues à la saphène interne, ont été libérées et tout le paquet a été fortement attiré en haut et en dedans
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    none: Fig. 121. La masse ganglionnaire n'est plus retenue que par la crosse de la saphène et par les adhérences du ganglion de Cloquet avec la veine crurale
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    none: Fig. 122. Le trois pédicules vasculaires sont liés (en haut, le pédicule sous-cutané abdominal ; en dedans, le pédicule ou plutôt les deux pédicules honteux externes ; en dehors, le pédicule circonflexe iliaque)
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