. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 177.—Pan-hysterectomy. (Wertheim.) By dividing the posterior layerof the broad ligament the ureters are exposed up to their entrance into the para-metrium. Gloves, instruments, drapes, and gowns all should be care-fully changed before the abdominal operation is patient is elevated into the Trendelenburg position before 338 OPERATIONS UPON THE UTERUS AND ITS LIGAMENTS the abdomen is opened, and as soon as the incision is made theintestine is packed away above the pelvic brim. This packingshould be done m
. A manual of gynæcology and pelvic surgery, for students and practitioners. Fig. 177.—Pan-hysterectomy. (Wertheim.) By dividing the posterior layerof the broad ligament the ureters are exposed up to their entrance into the para-metrium. Gloves, instruments, drapes, and gowns all should be care-fully changed before the abdominal operation is patient is elevated into the Trendelenburg position before 338 OPERATIONS UPON THE UTERUS AND ITS LIGAMENTS the abdomen is opened, and as soon as the incision is made theintestine is packed away above the pelvic brim. This packingshould be done most carefully so that nothing remains in the. Fig. 178.—Pan-hysterectomy. (Wcrtheivi.) After dividing the peritoneumthe bladder must be separated from the uterus. pelvic cavity but the fixed viscera. The suitability of the casefor radical operation is next determined, as it is impossibleto be certain before the abdomen is opened whether radical PAN-HYSTERECTOMY FOR CARCINOMA 339 extirpation offers a sufficient hope of permanent cure to justifythe risk. The earlier the case the more justification for an ex-tensive operation.
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