This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1903 Excerpt: ...up to the point of cutting across the cervix. Some operators prefer to complete the supravaginal amputation and then remove the cervix separately. This can be easily done, and is sometimes more convenient of execution than to remove the entire mass together, especially in the case of a bulky fibroid. Usually, however, it is better not to make two bites of a cherry, and the cervix and body are removed together. It matters little whether the vagina is entered from the front or back of the cervix, the only necessary precaution being not to perforate the bladder, on the one hand, or the rectum, on the other. If both uterine arteries have been ligated, the cervix may be cut boldly away after stripping down the bladder and making the initial opening into the r vagina. Reed leaves a shell of the cervix to avoid hemorrhage from the azygos and other minor branches. In the intraligamentous growth, however, where the section has been carried down on one side of the uterus, including the ligation of the uterine artery on that side, the technique as devised by Prior is probably the most feasible. It is substantially as follows: A pair of sharp-pointed scissors, or, better still, the perforating forceps of the author is thrust through Douglas's pouch into the vagina (being careful to keep close to the cervix) and spread so as to enlarge the opening sufficiently to admit two fingers. Two fingers of the left Fig. 227.--Abdominal Hysterectomy. (Kelly's Method.) The forceps are shown grasping the right uterine artery. hand are pushed through the opening into the vagina and hooked over the cervix, to act as guides for entering the vagina in front. When the anterior opening has been made both openings are stretched by the fingers or forceps until they extend beyond the sides o...
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