. Anatomy, descriptive and applied. Anatomy. 1412 THE UBINOGENITAL ORGANS may be performed in any case in which the uterus or the uterus and tumor are not too large to be withdrawn through the vagina. It is difficult in this operation to deal with adhesions and other complications in the upper part of the pelvis, and for this reason many surgeons prefer the abdom- FimirinteA extremity of t (he /rw> Fallopian tube '^. I ugma, aiae Fig. 11S7.—The uterus and its appendages. Posterior ^-iew. The parts have been somewhat displaced from their proper position in the preparation of the specimen; th
. Anatomy, descriptive and applied. Anatomy. 1412 THE UBINOGENITAL ORGANS may be performed in any case in which the uterus or the uterus and tumor are not too large to be withdrawn through the vagina. It is difficult in this operation to deal with adhesions and other complications in the upper part of the pelvis, and for this reason many surgeons prefer the abdom- FimirinteA extremity of t (he /rw> Fallopian tube '^. I ugma, aiae Fig. 11S7.—The uterus and its appendages. Posterior ^-iew. The parts have been somewhat displaced from their proper position in the preparation of the specimen; thus, the right ovary has been raised aboA'e the Fal- lopian tube, and the fimbriated extremities of the tube have been turned upward and outward. (From a prepa- ration in the Museum of the Royal College of Surgeons of England.) inal operation. Vaginal hysterectomy is performed by placing the patient in the lithotomy posi- tion and introducing a large duckbill speculum into the vagina. The cervix is then seized with a volsellum and pulled down as far as possible and the mucous membrane of the vagina incised around the cervix as near to it as the disease will allow, especially in front, where the ureters are in danger of being wounded. A pair of dressing forceps are then pushed through into Douglas' pouch and opened sufficiently to allow of the introduction of the two forefingers, by means of which the opening is dilated laterally as far as the sacrouterine ligaments. A some- what similar proceeding is adopted in front, but here the bladder has to be separated from the anterior wall of the uterus for about an inch before the vesicouterine fold of peritoneum can be reached. This is done by carefully burrowing upward with a director and stripping the tissues from the anterior uterine wall. When the vesicouterine pouch has been opened and the opening dilated laterally, the uterus remains attached only •by the broad ligaments, in which are con- tained the vessels that supply the u
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanatomy, bookyear1913
