Operative gynecology : . (see Fig. 342). The cervix is first drawn down toward the vaginal outlet as far as it will 606 VAGINAL HYSTERECTOMY. come, often outside, and an assistant on either side holds back the lateral vaginalwalls with a retractor so as to prevent them from hiding the field of operator, pulling on the traction ligatures, now makes a circular incisionaround the cervix and through the entire thickness of the vaginal vault, not lessthan 2 cm. (f inch) distant from the margin of the disease (see Fig. 343).The Paquelin or galvano-cautery may be employed in this stage
Operative gynecology : . (see Fig. 342). The cervix is first drawn down toward the vaginal outlet as far as it will 606 VAGINAL HYSTERECTOMY. come, often outside, and an assistant on either side holds back the lateral vaginalwalls with a retractor so as to prevent them from hiding the field of operator, pulling on the traction ligatures, now makes a circular incisionaround the cervix and through the entire thickness of the vaginal vault, not lessthan 2 cm. (f inch) distant from the margin of the disease (see Fig. 343).The Paquelin or galvano-cautery may be employed in this stage of the opera-tion, instead of a knife, to check the oozing. Moderate bleeding from itsmargins may be disregarded until the close of the operation. More profusebleeding should be controlled at once by ligatures passed through the vaginalwalls, so as to grasp the vessels. The knife or scissors are now laid aside, and the operator begins to pushup and peel back the cellular tissue from its cervical attachments in front and. Fig. 344.—Vaginal finger is engaged in pushing up the bladder, detaching it from the cervix. behind the cervix with index and middle fingers (see Fig. 344). There isusually no resistance and rarely any serious hemorrhage, for the importantblood vessels lie in the broad ligaments at the sides. Care must be taken inpushing back the tissues and freeing the cervix to keep the ball of the fingeralways directed toward the cervix. If the separation is carelessly performed
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
