The diseases of women : a handbook for students and practitioners . Fig. 113.—A uterine myoma extruded through an incision in the linea alba. The perito-neum is reflected to show the uterine arteries (A. E. G.). thus able to peel the peritoneum and bladder from theuterus. A similar transverse incision is made across the posteriorsurface of the tumor, and the peritoneum on that aspect iscarefully peeled off. When this manoeuvre is properly car-ried out the layers of the broad ligaments are directly con- OPERATIONS ON THE UTERUS. 413 tinuous with each other, the cervix of the uterus standingup f
The diseases of women : a handbook for students and practitioners . Fig. 113.—A uterine myoma extruded through an incision in the linea alba. The perito-neum is reflected to show the uterine arteries (A. E. G.). thus able to peel the peritoneum and bladder from theuterus. A similar transverse incision is made across the posteriorsurface of the tumor, and the peritoneum on that aspect iscarefully peeled off. When this manoeuvre is properly car-ried out the layers of the broad ligaments are directly con- OPERATIONS ON THE UTERUS. 413 tinuous with each other, the cervix of the uterus standingup freely between them. The operator now proceeds to ligature the uterine arteryon each side. He selects a stout aneurysm-needle set at aright angle, armed with a stout silk ligature, and passes itaround the vessel at the spot where it passes on to the cervix(Figs. 113 and 114), and ties it securely. Having ligatured thevessel on both sides, he then cuts the uterus at the level to. r^M,* Owes Round hj Fig. 114.—A stage in abdominal hysterectomy, showing a method of securing the uterinearteries (Howard Kelly). which he has reflected the peritoneum. Sometimes a smallvessel may bleed in the stump and needs to be the uterine arteries are clearly seen, and they maythen be deliberately tied as in an amputation stump. The floor of the pelvis and the parts exposed between thesplit broad ligaments are carefully sponged and freed fromblood and clots, and the peritoneal flaps are now carefullysutured together, so as to exclude the stump from the pel-vic cavity. The abdominal wound is then sutured in theusual manner. 4H DISEASES OE WOMEN. After-treatment.—This is conducted on the same lines asafter ovariotomy, and, as a rule, the convalescence is asquick. The special risks in this operation are hemorrhage; injuryto one or both ureters or the bladder; and infection of theperitoneum through the cervical canal. {b) Pan-hysterectOtny.—This signifies the remo
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgen, booksubjectwomen
