. Gynecology : . for Prolapse and Procidentia PROCIDENTIA The technic usually employed by the author for advanced cases of procidentiais as follows: (1) High amputation of the cervix is performed by the Hegar method de-scribed on page 599. (2) An extensive anterior colpoplasty is then done by the authors methoddescribed on page 608. OPERATIONS FOR UTERINE MALPOSITION 697 (3) Perineoplasty is performed according to the technic described for themodified Emmet operation on page 625. (4) The patient is then placed in the Trendelenburg position, the abdomenopened by a small incision, and the uterus
. Gynecology : . for Prolapse and Procidentia PROCIDENTIA The technic usually employed by the author for advanced cases of procidentiais as follows: (1) High amputation of the cervix is performed by the Hegar method de-scribed on page 599. (2) An extensive anterior colpoplasty is then done by the authors methoddescribed on page 608. OPERATIONS FOR UTERINE MALPOSITION 697 (3) Perineoplasty is performed according to the technic described for themodified Emmet operation on page 625. (4) The patient is then placed in the Trendelenburg position, the abdomenopened by a small incision, and the uterus and adnexa removed by the technicdescribed for supravaginal hysterectomy (see page 713). (5) When the uterus has been amputated, the cervix closed, and the uterinevessels tied, two sutures of No. 7 braided silk are passed deeply, one on eachside of the cervix (Fig. 355). the ends being left long and the needles sutures are to serve later to attach the cervical stump to the anteriorabdominal Fig. 355.—Operation for Procidentia (Authors Method).The uterine body has been amputated and the broad ligaments sewed to the cervical strong silk sutures have been introduced through the firm tissue of the cervical stump, which areto be used to attach the stump to the anterior abdominal wall. The bladder flap is being drawn upand is to be attached to the posterior wall of the vagina, so that it entirely covers the cervical stumpand the attached stumps of the broad ligaments. The broad ligaments are then sewed to the stump of the cervix in the samemanner as in supravaginal hysterectomy (Fig. 381). The next step resembles the turning over of the uterovesical flap of perito-neum (Fig. 382), except that in this case the bladder is dissected away fromthe vagina for a considerable distance. The peritoneal fold is then carried farover the stump of the cervix and attached low down toward the pouch of Douglasto the posterior wall of the vagina. In this way the cerv
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