Gynecology . ?G-^ Fig. 316.—Spinellis Operation for uterus has been reinverted. In orderto secure approximation of the edges of thewound in the uterine wall it has been necessaryto remove wedges of tissue on each side, as isshown in the \W .?.^> Fig. 317.—Spinellis Operation for Inver-sion. Closure of the incision of the cervix and anteriorwall. The uterus is reinverted by placing the forefingers at the cervix for coun-terpressure, and forcing the fundus upward by the thumbs in the mannerthat one would naturally use in turning a tennis ball inside out through acut i
Gynecology . ?G-^ Fig. 316.—Spinellis Operation for uterus has been reinverted. In orderto secure approximation of the edges of thewound in the uterine wall it has been necessaryto remove wedges of tissue on each side, as isshown in the \W .?.^> Fig. 317.—Spinellis Operation for Inver-sion. Closure of the incision of the cervix and anteriorwall. The uterus is reinverted by placing the forefingers at the cervix for coun-terpressure, and forcing the fundus upward by the thumbs in the mannerthat one would naturally use in turning a tennis ball inside out through acut in its side. When the uterus has been restored to its original form, the next step is toclose the incision in its wall. It will, however, be found that, owing to theshrinking which the peritoneum has undergone in its inverted position, it can- OPERATIONS FOR UTERINE MALPOSITION 613 not be approximated, the tissue of the uterine wall pouting out in the mannerof an ectropion. The excessive tissue must be trimmed away in the form oflongitudinal wedges, as seen in Fig. 316, when the peritoneal edges may becoaptated without difficulty. The wound of the uterine wall is closed withtwo rows of continuous catgut sutures. The first suture includes and firmlyunit
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