Gynecology . Fig. 292.—Alexander-Adams Operation for the peritoneum. By traction on the round ligament the peritoneum is drawn up in a funnel-shaped fold (after Doderlein-Kronig). The peritoneal reflection is now opened (Fig. 292), and the operation up tothis point repeated on the other side. The forefingers of the two hands are now introduced into the peritonealcavity, as in Fig. 291, and the pelvis explored. By this maneuver the positionof the uterus is controlled. When the desired position is attained the ligamentsare sewed to the under side of the outer flap of fascia
Gynecology . Fig. 292.—Alexander-Adams Operation for the peritoneum. By traction on the round ligament the peritoneum is drawn up in a funnel-shaped fold (after Doderlein-Kronig). The peritoneal reflection is now opened (Fig. 292), and the operation up tothis point repeated on the other side. The forefingers of the two hands are now introduced into the peritonealcavity, as in Fig. 291, and the pelvis explored. By this maneuver the positionof the uterus is controlled. When the desired position is attained the ligamentsare sewed to the under side of the outer flap of fascia and the redundant portioncut off. In order to guard against possible postoperative hernia the edge of the OPERATIONS FOR UTERINE MALPOSITION 591. Fig. 293.—Alexander-Adams Operation for of peritoneal opening and suture of the round ligament to the under side of the fascia (after Doderlein-Kronig). conjoined tendon is attached by a few stitches to Pouparts ligament,wound is closed by overlapping the fascia layer. The Operations for Anteflexion PESSARIES FOR ANTEFLEXION OF THE CERVIX As has been stated (see page 407), the use of intra-uterine pessaries is un-surgical in principle, and may be followed by inflammatory processes in thetubes, of which we have observed two instances. Nevertheless, even with thisrisk the procedure is regarded as justifiable and is very widely employed. Ifapplied to the proper cases the results gained by pessaries, both for dysmenor-rhea and sterility, are comparatively good. Numerous forms of pessaries are in use, some of which require sutures inthe cervix to keep them in place, others being self-retaining in principle. Wegreatly prefer the latter type, as the sutures used for se
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