The practice of surgery . tion. We are as yet far from being able to remove the utenis through thevagina with such ease and clearness of vision, looking to lymphaticinvolvements, as in removing the breast and its associated lymph-nodes. TUMORS OF THE UTERUS 315 The presence of the ureters, lying within one-half inch of the cervix,renders almost impossible a wide and sure dissection by the vaginalroute. In spite of these facts the vaginal route will always be a favoriteroute with operators, because in early cases the dissection is easy, theoiKM-ative mortality low, the immediate results briUian
The practice of surgery . tion. We are as yet far from being able to remove the utenis through thevagina with such ease and clearness of vision, looking to lymphaticinvolvements, as in removing the breast and its associated lymph-nodes. TUMORS OF THE UTERUS 315 The presence of the ureters, lying within one-half inch of the cervix,renders almost impossible a wide and sure dissection by the vaginalroute. In spite of these facts the vaginal route will always be a favoriteroute with operators, because in early cases the dissection is easy, theoiKM-ative mortality low, the immediate results briUiant, convalescenceshort, discomfort slight, and recurrence reasonably infrequent. Abdominal Hysterectomy for Cancer.—This operation is shown bystatistics to be more fatal than vaginal hj^sterectomy, but such statisticsare misleading, because abdominal hysterectomy is extremely difficultor impossible in the case of fat women, whose thick abdominal wallsand densely packed pelves render manipulations difficult or Fig. 198.—Vaginal hysterectomy—step 8 (adapted from Dudley). Moreover, abdominal hysterectomy is commonly practised in the moreadvanced and complicated cases. The development of abdominal hysterectomy for cancer of the uterushas been stimulated latel5\ in this countr}- especially, by the researches,practice, and preaching of John A. Sampson,^ but his extremely inter-esting and radical operation has not yet found entire favor with theprofession, on account of the difficulty of following his technic withouta-resulting high mortality. I am convinced, however, that a morefrequent resort to a modified, but still radical, abdominal hysterectomyfor cancer of the uterus will result in improving our statistics. 1 John A. Sampson, Jour. Amer. Med. Assoc, October 29, 1904; May 20,1905. 316 FEMALE ORGANS OF GENERATION The Operation.—With the patient well elevated in Trendelenburgsposition and the intestines carefully isolated (the maneuver of stitchingthe pa
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
