Transactions of the American Association of Obstetricians and Gynecologists for the year ... . illustrated in drawing No. i. The fascial flap is drawn through theloop of ligament replaced in its original position and sutured you will observe, the loop of the ligament is buried underneaththe fascia and cannot escape and slide back into the abdominalcavity. Not infrequently the loop of ligament on one side is shorter than 286 JOHN NORVAL BELL, the other. Where such a condition exists the fascial flap can be cutnarrower. In other words the flap can be cut to accommodatethe length of lo
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . illustrated in drawing No. i. The fascial flap is drawn through theloop of ligament replaced in its original position and sutured you will observe, the loop of the ligament is buried underneaththe fascia and cannot escape and slide back into the abdominalcavity. Not infrequently the loop of ligament on one side is shorter than 286 JOHN NORVAL BELL, the other. Where such a condition exists the fascial flap can be cutnarrower. In other words the flap can be cut to accommodatethe length of loop. It will be seen, therefore, that we have thefreshly cut edges of the fascia lying in apposition and union shouldbe firm and prompt. It is understood that all necessary plasticwork should be done in the perineum and vagina. tOc* II .. DISCUSSION ON THE PAPER OF DR. BELL. Dr. Albert Goldspohn, Chicago.—Mr. President: the doctorscreditable modification and general technic is within the bounds ofwhat I consider fundamental principles in correct retroversion sur-gery. However, I would say in regard to this, and in regard to theGilliam operation, that in order to have thorough and stable results, BURIED LOOP OPERATION. 287 it needs to be amplified in one direction, viz., in order to make thefundus uteri rest against the abdominal wall just above the bladdermore thoroughly and uniformly, the round ligament must be sepa-rated from the tube by severing the peritoneal coat that envelopesboth of them near their origin, so that the loop of round ligament,which must take in a generous portion of its enveloping peritoneum,will exercise its lifting function more directly upon the fundus latter should not only leave no space between itself and theabdominal wall, but also leave no free space between itself and theblad
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