. Gynecology : . Fig. 376.—Supravaginal Hysterectomy. Second Step of vessels of the left side have been severed and the uterus is being amputated by a wedge-shaped incision. clamps to act as a sort of secondary defense. A ligature is introduced witha full-curved needle first into the tissue of the cervix inside the vessels, thenaround the vessels and tied. As the knot is tied the first or lower clamp isreleased. The ligature is then passed again in the same manner, and when tiedthe secondary clamp is removed. In this manner the uterine vessels are tiedtwice. By using the seconda
. Gynecology : . Fig. 376.—Supravaginal Hysterectomy. Second Step of vessels of the left side have been severed and the uterus is being amputated by a wedge-shaped incision. clamps to act as a sort of secondary defense. A ligature is introduced witha full-curved needle first into the tissue of the cervix inside the vessels, thenaround the vessels and tied. As the knot is tied the first or lower clamp isreleased. The ligature is then passed again in the same manner, and when tiedthe secondary clamp is removed. In this manner the uterine vessels are tiedtwice. By using the secondary clamp no blood is lost. The same procedureis carried out on the left. 718 GYNECOLOGY The next step, and a most important one, is the suspension of the cervicalstump by the broad ligaments in order to avoid a later prolapse, a complication £>]o3 CA. C\c*.Yi\v> on V ^t»oai> Lie Fig. 377.—Supravaginal left uterines have been clamped and cut. The uterus has been amputated by a wedge-shaped incision. The uterines of the right side have been reached and exposed by lifting the clamp now grasps the vessels, which are severed with as long a pedicle as possible. which, as we have emphasized (see page 129), is the most common cause for thephysical and nervous symptoms following hysterectomy. HYSTERECTOMY OPERATIONS 719
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