. Gynecology : . NM^Gy,. o$w Fig. 394.—Vaginal of the posterior vaginal wall (adapted from Doderlein-Kronig) into the surrounding tissue wall, for if this is made too thin it is liable to be rup-tured by the tension on the uterus necessary in the course of the later important reason for a not too thorough cureting is the possible danger 734 GYNECOLOGY of penetrating the peritoneal cavity, an accident which, on account of the viru-lent organisms always contained in the cancerous mass, is almost inevitablyfollowed by a fatal peritonitis. The preliminary op


. Gynecology : . NM^Gy,. o$w Fig. 394.—Vaginal of the posterior vaginal wall (adapted from Doderlein-Kronig) into the surrounding tissue wall, for if this is made too thin it is liable to be rup-tured by the tension on the uterus necessary in the course of the later important reason for a not too thorough cureting is the possible danger 734 GYNECOLOGY of penetrating the peritoneal cavity, an accident which, on account of the viru-lent organisms always contained in the cancerous mass, is almost inevitablyfollowed by a fatal peritonitis. The preliminary operation should be regarded also as a cureting and notas a cauterization, for if the latter is done a slough is produced, which duringits separation produces an unclean discharge, that acts as a source of dangerduring the later operation. After cureting away the cancerous masses the. Fig. 395.—Vaginal Hysterectomy. Sewing the peritoneum to the vaginal stump. The broad ligaments have been stitched to the vagina on each side (adapted from Doderlein-Kronig). crater is packed with iodoform gauze to prevent unnecessary loss of blood. Ifthe bleeding is considerable the vagina should also be packed. In about twenty-four hours the packing is removed. During the interval before the main opera-tion formalin douches (1 to 2 per cent.) are given daily. The patient is keptout of doors as much as possible and supporting treatment given for about aweek or ten days. The Operation.—A thorough bowel preparation is very necessary, so thatthe intestines may be well collapsed at the time of operation. The catharsis HYSTERECTOMY OPERATIONS 735 should be given the second night before the operation, so that the patient mayhave an undisturbed night preceding the operation. The usual abdominal andvaginal preparation is carried out. When the patient has been anesthetizedthe vagina is wi


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