Treatise on gynæcology : medical and surgical . emonstrates that thefirst of Sangers does not differ materially from Wolfler-Hackers, forthe two lateral sutures for the suspension of the uterus are replacedby the suture of the peritoneum to the posterior face of the to the second, it is practically Hegars method applied to a veryshort stump, where the suture around the pedicle is replaced by thesuture above it of the peritoneum; but it presents this originality,that the peritoneum is sutured (with catgut) above the elastic ligature TREATMENT OF FIBROUS TUMORS OF ABDOMINAL EVOLUTION. 2
Treatise on gynæcology : medical and surgical . emonstrates that thefirst of Sangers does not differ materially from Wolfler-Hackers, forthe two lateral sutures for the suspension of the uterus are replacedby the suture of the peritoneum to the posterior face of the to the second, it is practically Hegars method applied to a veryshort stump, where the suture around the pedicle is replaced by thesuture above it of the peritoneum; but it presents this originality,that the peritoneum is sutured (with catgut) above the elastic ligature TREATMENT OF FIBROUS TUMORS OF ABDOMINAL EVOLUTION. 29£ to the part which is intended to slough. Sanger powders the stumpwith a mixture of salicylic acid, iodoform, and tannin; to this I adda covering of iodoform gauze. Extirpation of the Pedicle—Total Hysterectomy.—-In those rarecases where the cervix is so full of fibrous tumors that it is impossibleto save a pedicle, we may be obliged to perform total , by placing an elastic ligature upon the capsule, it is almost. Fig. 162.—Treatment op the Pedicle by Saengers Mixed Method. Intra-peritoneal sequestration ofthe pedicle, with elastic ligature. I, elastic ligature; ut, posterior surface of uterus; p, pedicle (section);b, pins. always possible to save a pedicle in enucleating and excising the stump,and if this is too short to be maintained externally, the mixed methodmay be adopted or it may be abandoned in the peritoneum. The pro-cedures of Olshausen and Sanger do not seem to me less serious thantotal extirpation, even though Bardenheuer has recorded six success-ful cases with them in seven operations; his cases appearing to havebeen simple ones which would have recovered with any other cases published since then have not been very numerous, whichproves the legitimate objection to the application to fibroma ofFreunds operation for cancer, which is to-day 300 CLINICAL AND OPERATIVE GYNAECOLOGY. Of late, however, there has be
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