A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ll discuss under the head of Extirpation of theUterus. The removal of submucous tumors of the uterus whichare pedunculated (termed polypi) I will speak of under thehead of u Uterine Polypi. The non-penunculated, submucous, fibrous tumor of theuterus may be removed in the following manner by what iscalled enucleation: First of all, the os uteri must be as fullydilated as possible; or. it may be incised after the patientis placed under an anaesthetic, and we can then pass the hand,or at least two finge
A treatise on the medical and surgical diseases of women, with their homopathic treatment .. . ll discuss under the head of Extirpation of theUterus. The removal of submucous tumors of the uterus whichare pedunculated (termed polypi) I will speak of under thehead of u Uterine Polypi. The non-penunculated, submucous, fibrous tumor of theuterus may be removed in the following manner by what iscalled enucleation: First of all, the os uteri must be as fullydilated as possible; or. it may be incised after the patientis placed under an anaesthetic, and we can then pass the hand,or at least two fingers, high up into the uterus, having itsfundus pressed upon by assistants through the abdominalwall. We next pass up between the fingers we have intro-duced a long-handled bistoury, and make an incision into thetumor as long as convenient. We now withdraw the instru-ment, and peel back the coverings of the tumor as well aswe can, and if we can entirely detach the tumor from itsinclosed sheath in this way, aided by the use of Simsenucleators, it is best; but if it can only be partially de- ^. Fig. No. 34.—Sims Enucleators. tached we should seize the detached portion with the vul-sellum forceps (see Plate X), or Nektons forceps (see PlateXI), and as we make traction with them continue to attemptto make further separation with the fingers or the tumor can not be extracted entire, it may be torn 348 EATON ON DISEASES OF WOMEN. off piecemeal, scraping the interior of the sac with the circu-lar sharp enucleators or curettes (using care not to injure theuterus), thus removing all of the tumor, as I did in a caseof this kind in a lady from Kentucky last year (and madea success of the operation). The tumors vitality in thiscase seemed io have been lost by the use of sponge-tents,used in dilating the os. and it became quite soft, althoughon the first attempt at dilatation, six weeks before, the tumorwas solid and firm. In case we can draw down the enucleated tumor to them
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Keywords: ., bookcentury1800, bookdecade1880, bookpublishere, booksubjectwomen
