Abdominal surgery . ration. CERVICAL AMPUTATION. 217 CERVICAL AMPUTATION. Although this operation for cervical cancer is not strictlywithin the limits of this work, and was omitted in the firstedition, I now include it, because it is germane to what follows,and because it makes complete the account of the operativetreatment of uterine cancer. I confine my description to a shortaccount of the operation which I have performed for the pastfive years with uniform success. The cases are too few todraw conclusions from; but, judging from the behaviour ofpatients submitted to the operation, I believe
Abdominal surgery . ration. CERVICAL AMPUTATION. 217 CERVICAL AMPUTATION. Although this operation for cervical cancer is not strictlywithin the limits of this work, and was omitted in the firstedition, I now include it, because it is germane to what follows,and because it makes complete the account of the operativetreatment of uterine cancer. I confine my description to a shortaccount of the operation which I have performed for the pastfive years with uniform success. The cases are too few todraw conclusions from; but, judging from the behaviour ofpatients submitted to the operation, I believe that one may go on operat-ing with amortalityunder 2 percent. The va-gina is dis-infectedthoroughlyby irriga-tion beforeoperation,and byswabbingat the timeof opera-tion. Thepatient isplaced inthe litho-tomy posi-tion andkept thereby means of Clovers crutch. (Fig. 33.) The cervix is caught in power-ful locking volsella, by means of which the uterus is forciblydragged down: these are handed over to an? assistant, who. Fig. 33. Clovers Cniich. One-eighth size. 218 KOLPO-HYSTERECTOMY. directs the movements of the uterus according to the instruc-tion of the surgeon. The only instruments necessary are, twoSpencer Wellss large compression forceps, a scissors curvedon the flat, and a straight uterine probe. The mucous membrane surrounding the cervix, well clear ofthe disease, is divided circularly with the scissors. With theforefinger of the left hand, and the scissors in the right, thecervical mucous membrane is dissected or peeled off in anupward direction, in front and behind, but not at the sides, ashigh as possible. The dissection is made close to the uterus infront to avoid the bladder and ureters, and behind to avoidperforation of the peritoneum ; the dissection may be carriedhigher in front than behind. Practice on the cadaver will soonenable one to judge by touch when the upward limits of safetyhave been reached ; these are known by the increased resistancemet with. At the si
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