Treatise on gynæcology : medical and surgical . p-splitting (Doleris40 method).—Thisis an ingenious combination of Lawson-Taits flap-splitting, Schrodersremoval of the mucous membrane, and Emmets suture, and is chieflyapplicable where the uterine prolapse is only slightly marked, butwhere the vulva gapjes so widely that there is danger of vaginal PP0LAPSE OF THE GENITAL OPGANS. rM prolapse, with or without partial laceration of the perineum. Itstrengthens the perineum by increasing its length and thickness,without any vaginal suture, and is rapidly performed. The weakpoint of the process is th
Treatise on gynæcology : medical and surgical . p-splitting (Doleris40 method).—Thisis an ingenious combination of Lawson-Taits flap-splitting, Schrodersremoval of the mucous membrane, and Emmets suture, and is chieflyapplicable where the uterine prolapse is only slightly marked, butwhere the vulva gapjes so widely that there is danger of vaginal PP0LAPSE OF THE GENITAL OPGANS. rM prolapse, with or without partial laceration of the perineum. Itstrengthens the perineum by increasing its length and thickness,without any vaginal suture, and is rapidly performed. The weakpoint of the process is the shortening of the posterior vaginal wall,which interferes with any ascent of the uterus, and thus renders it ofdoubtful utility in cases of marked prolapse. It cannot be combinedwith Alexanders operation, as can Hegars and Martins , it does not contract the vagina itself, but only the vulvarorifice, and is in fact merely a perineoplasty, since the portion ofvagina removed is very small. With a bistoury, Doleris makes a deep. Fig. 280.—Colpo-Perineorrhaphy by Bischoffs Method. curved incision at the juncture of skin and mucous membrane. For-ceps are inserted at the two ends of the incision, to stretch the upper, mucous lip of the wound is dissected slightly from thesubmucous tissue, and then uplifted by forceps. The operator, nowusing the index finger of the left hand instead of an instrument,gently pushes the tissues apart, separating the vaginal and rectalwalls as far as necessary. The vaginal flap is now drawn outside ofthe vulva and resected, and its edge then united to the edge of the firstincision with curved needles and three strands of heavy silkwormgut. The first stitch is in the centre; it is inserted just to the left ofthe anus, goes deeply through the tissues, and into the vaginal flapclose to the wall, entering the vagina or not as the operator prefers; 504 CLINICAL AND OPERATIVE GYnSTYECOLO&Y. it is then brought back in the same m
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Keywords: ., bookcentury1800, bookdecade1890, booksubje, booksubjectgynecology
