. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 134. Fig. 135. Fig. 134.—Vaginal hysterectomy. Cervico-vaginal attachment has beensevered by a circular incision and flap rolled back; anterior view. Fig. 135.—Vaginal hysterectomy. Cervico-vaginal junction has been severedand flap rolled back. Clamps on bases of broad ligaments; posterior view. It isoptional whether clamps be placed now or Fig. [136.—VaginaH of peritoneum after strip-ping bladder from cervix. Broad liga-ment bases clamped. Fig. 137.—Vaginal fingers
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 134. Fig. 135. Fig. 134.—Vaginal hysterectomy. Cervico-vaginal attachment has beensevered by a circular incision and flap rolled back; anterior view. Fig. 135.—Vaginal hysterectomy. Cervico-vaginal junction has been severedand flap rolled back. Clamps on bases of broad ligaments; posterior view. It isoptional whether clamps be placed now or Fig. [136.—VaginaH of peritoneum after strip-ping bladder from cervix. Broad liga-ment bases clamped. Fig. 137.—Vaginal fingers are inserted into the open-ing between the bladder and uterus inorder to anteflex the fundus into thevagina. VAGINAL HYSTERECTOMY 291 usually requires snipping with a scissors whose points are keptin contact with the cervix. Dry dissection with the finger iscontinued anteriorly and posteriorly until the peritoneum ap-pears in the depths of the wound. This is recognized by itsthinness and the fact that it moves independently of the visceraabove it. The peritoneum may be torn through with the fingers,or caught and cut as in opening the abdomen through the an-terior wall. Both anterior and posterior openings through theperitoneum are torn laterally by the introduction of the fore-fingers of either hand, after which the uterus is found to besuspended by the broad ligaments and the structures betweentheir folds. Two metho
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