A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . istula than incases of vesico-vaginal fistula. Theneedle must be inserted, so thatwhen the suture is tightened theprotruding tissues are turned backinto the urethra, and the vaginalmembrane is brought together over them. Either the straightor my curved needle holder may be used, as the rent is sit-uated longitudinally or transversely to the axis of the vag-ina—the straight holder being most convenient in insertingthe needle from side to side (see Fig. No. 55), and my curvedholder if we haA^e to inser
A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . istula than incases of vesico-vaginal fistula. Theneedle must be inserted, so thatwhen the suture is tightened theprotruding tissues are turned backinto the urethra, and the vaginalmembrane is brought together over them. Either the straightor my curved needle holder may be used, as the rent is sit-uated longitudinally or transversely to the axis of the vag-ina—the straight holder being most convenient in insertingthe needle from side to side (see Fig. No. 55), and my curvedholder if we haA^e to insert it from above downwards, orvice versa. (See Fig. No. 56.) After the wire is insertedthe ends of the wire are passed through the eyes of my wireholder and twister (Plate VI), and the wire tightened aswe draw gently upon the ends of the wire, and carry theholder down firmly against the vaginal tissues, at the sametime aiding the turning in of the prolapsed vesical tissuewith the finger of the left hand while we hold the twisterwith our right, at the same time grasping the wires, together. Fig. No. 56. 528 EA TON ON DISEASES OF WOMEN. with the handle of the instrument. Twisting the wires oncearound the index finger of the right hand, enables us tomake traction upon the wire, and press the instrument upagainst the fistula firmly, and gives us the use of the left toturn in the excess of tissue at the same time. After theraw vaginal surfaces of the opposite sides of the fistula arebrought together the twister is to be turned around aboutthree times to secure the suture, when the instrument iswithdrawn and the wire cut as before. In case the urethro-vaginal fistula is of several months oryears standing it becomes necessary to freshen the edges ofthe fistula before taking the sutures. In this part of theoperation care is to be exercised not to sut the prolapsedcystic tissue. A small tenaculum is convenient to lift up thevaginal tissue around the fistula, so that we can incise it wi
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