American gynaecological and obstetrical journal. . nline, is caught up at A and passing over the intervening tissue of thecervical stump the needle is made to enter at B and is then broughtout from the uterine canal. Just opposite, another suture is to bepassed from within through the edge of the uterine canal and brought out at C, thenpassing over the stumpit is made to catch upthe edge of the vaginaltissue and to be drawnout at D. If we followthe course of either ofthese sutures it will beapparent that when thefront suture, for in-stance, is twisted thefree vaginal surface mustbe drawn over
American gynaecological and obstetrical journal. . nline, is caught up at A and passing over the intervening tissue of thecervical stump the needle is made to enter at B and is then broughtout from the uterine canal. Just opposite, another suture is to bepassed from within through the edge of the uterine canal and brought out at C, thenpassing over the stumpit is made to catch upthe edge of the vaginaltissue and to be drawnout at D. If we followthe course of either ofthese sutures it will beapparent that when thefront suture, for in-stance, is twisted thefree vaginal surface mustbe drawn over thestump and as the edgeof the uterine canal is afixed point the portionat A will be secured atB; also when the poste-Mode of Introducing the Sutures in rjor suture has beenEmmets Amputation of the twisted in the same Cervix Uteri. manner the portion at D will be drawn overto C. The result of thus securing these sutures will be thatthe edge of the divided mucous membrane on the vaginal sur-face, front and back, will be rolled over in contact with. IV hen to Amputate in Preference to the Repair of a Lacerated Cervix. 351 the edges of the uterine canal and when primary union has takenplace the natural caliher of the passage must be preserved. But be-fore securing these, or any of the sutures, as many as may be deemednecessary should be first introduced on each side in die manner in-dicated by the sutures E F. Here the loose vaginal edge at E isfirst caught up and then the needle is made to include a sufficientportion of the uterine stump at G, on a line with the uterine canal,and in turn it should take up the vaginal tissue behind and bebrought out at F. The only difficulty is in catching up enough ofthe uterine tissue in the centre of the stump to hold it firmly in con-tact with the Haps after the sutures have been secured. But thisdifficulty can be overcome by using a properly-shaped needle withthe pointed end slightly bent on itself. The passage of the needleis greatly facilit
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Keywords: ., bo, bookcentury1800, booksubjectgynecology, booksubjectobstetrics
