Treatise on gynæcology : medical and surgical . e-cause of the probability of secondary hemorrhage, mortification, andsepticaemia. Sangers Method.—Intra-peritoneal sequestration (Abkapselung).—Sanger thus designates an operative procedure which consists ofsuturing the peritoneum closely about the pedicle, drawing upon theparietal peritoneum for this purpose, and fixing it along the posterior 298 CLINICAL AND OPEEATIVE GYNECOLOGY. face of the stump. The abdominal cavity is thus separated from itslower division, in which lies the sequestrated pedicle. Sanger distinguishes two modifications of th
Treatise on gynæcology : medical and surgical . e-cause of the probability of secondary hemorrhage, mortification, andsepticaemia. Sangers Method.—Intra-peritoneal sequestration (Abkapselung).—Sanger thus designates an operative procedure which consists ofsuturing the peritoneum closely about the pedicle, drawing upon theparietal peritoneum for this purpose, and fixing it along the posterior 298 CLINICAL AND OPEEATIVE GYNECOLOGY. face of the stump. The abdominal cavity is thus separated from itslower division, in which lies the sequestrated pedicle. Sanger distinguishes two modifications of this procedure: 1. The pedicle is sutured by Schroders method but, hemorrhagebeing probable, it is sequestrated by suturing to it the parietal perito-neum, with drainage (Fig. 161). 2. The pedicle is too short to be drawn out of the abdomen. Thetransfixing pins are placed some distance above the elastic ligature,which is disposed as in Hegars method. The peritoneum is thensutured to the upper part of the pedicle in front of the elastic liga-. Fig, 161.—Sangers Mixed Treatment of the Pedicle; Intra-peritoneal Sequestration of a PedicleSutured by Schroeders Method, pp, Parietal peritoneum sutured to posterior surface of stump; u,uterine pedicle; v, vagina; d, drainage. ture, to sequestrate it from the abdominal cavity. A barrier is thusformed above, making the elastic ligature extra-peritoneal and yetintra-abdominal (Fig. 162). Sanger has thus obtained great successwith a stump which was very short, thick, and hemorrhagic. A careful study of these two methods demonstrates 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 origina
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