. A manual of operative surgery . Herman points out(Diseases of Women, 3rd edition, page 726) that long beforeLawson Tait published his account of the method J. Hutchinson(senior) practised and taught it. The principle is to remove notissue but to reconstitute the perineal body by means of lateralsutures after completely splitting the septum transversely. chap, xviii] LAWSON TAITS OPERATION 471 Roughly speaking, it consists in converting the capital H into Fig. 128, the line b e represents the transverse incision ; tothis is added an incision passing forwards and a little outwardson eithe
. A manual of operative surgery . Herman points out(Diseases of Women, 3rd edition, page 726) that long beforeLawson Tait published his account of the method J. Hutchinson(senior) practised and taught it. The principle is to remove notissue but to reconstitute the perineal body by means of lateralsutures after completely splitting the septum transversely. chap, xviii] LAWSON TAITS OPERATION 471 Roughly speaking, it consists in converting the capital H into Fig. 128, the line b e represents the transverse incision ; tothis is added an incision passing forwards and a little outwardson either side for an inch or more (b a and e d), and two shorterincisions passing for half an inch backwards and outwards (b cand E f). These latter incisions lie in reality nearer to therectal wall than they appear in the figure. These incisions aresteadily deepened with scissors or scalpel, taking care not toopen either rectum or vagina, the fingers of the operators lefthand being introduced into the rectum to guard against this. (XA. FIG. 128.—LAWSON TAITS OPERATION FOR RUPTURED PERINEUM. (For explanation see text.) A deep wound is thus made having four curved (concave) sides,A c f d in Fig. 128. Ultimately the rectal and vaginal wallsare so separated and drawn backwards and forwards as toallow abc and d e f to be approximated. Silkworm gut onlarge curved needles is then passed on either side (1, 2, 3, 4 inFig. 129), taking a firm hold and traversing the tissues to thebottom of the wound. If the edge of the vaginal wall ad orof the rectal wall c f is redundant, a triangular piece of mucousmembrane is excised, and the small wound closed with interruptedsutures of catgut. These catgut sutures would be knotted onthe vaginal and rectal sides respectively. The Clovers crutchis removed. The main silkworm-gut stitches are then tied 472 ABDOMINAL OPERATIONS [PART II firmly, and a light gauze dressing applied. The urine shouldbe drawn off with the catheter three times a day. The mainsutur
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