The diseases of women : a handbook for students and practitioners . sthetizedand fixed in the lithotomy position, and the cervix wellexposed by means of the duck-bill speculum. The cervixis then secured by the reversible tenacula-forceps, as shownin Fig. 105. By means of scalpel and forceps the operatordissects flaps from the exposed surfaces of the cervix, takingcare to preserve a narrow strip of mucous membrane in themiddle line (Fig. 106), which will form the lining for the newcervical canal when the flaps are approximated. Whilstthe surfaces are being vivified there is usually free oozing:
The diseases of women : a handbook for students and practitioners . sthetizedand fixed in the lithotomy position, and the cervix wellexposed by means of the duck-bill speculum. The cervixis then secured by the reversible tenacula-forceps, as shownin Fig. 105. By means of scalpel and forceps the operatordissects flaps from the exposed surfaces of the cervix, takingcare to preserve a narrow strip of mucous membrane in themiddle line (Fig. 106), which will form the lining for the newcervical canal when the flaps are approximated. Whilstthe surfaces are being vivified there is usually free oozing:this is useful, as it serves to deplete the cervix and dimin-ishes its volume. 363 OPERATIONS ON THE UTERUS. 369 The cervical flaps are now brought together and retainedin apposition by the reversible tenacula-forceps (Fig. 106):this instrument enables the operator to manipulate the cer-vix during the introduction of the sutures. For this pur-pose a slightly curved needle on a handle is very sutures may be of silver wire, silkworm gut, or silk, se-. Fig. 105.—Trachelorrhaphy : Stage i. The cervix seized with the reversible tenacula-forceps (A. E. G.)- cured with shot and coil (Fig. 107). Silkworm-gut suturessecured by knots are quite sufficient. When the sutures are fastened, a sound is passed into theuterus to ensure that the cervical canal is free. The partsare then carefully dried and the vagina lightly stuffed withiodoform gauze. 24 370 DISEASES OF WOMEN. After-treatment.—This consists in keeping the vagina asdry as possible. When there is discharge, and irrigation is required, then the vagina shouldbe carefully dried after eachdouche. Sutures are removed on thetenth day; for this purpose thepatient is placed in the lithot-omy position, facing a good light:with very nervous patients ananaesthetic is necessary. Amputation of the CervixUteri.—Amputation of the neckof the uterus is performed forepithelioma, cancer, and hyper-trophic elongation. The methods
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