. Operative gynecology. it, as it were, from its peritoneal doing this and then cutting through the peritoneum reflected from thebowel onto the tumor, it may be from beneath instead of from above, the rec-tum at once drops into its normal position in the pelvis. The operation maythen be completed in the ordinary way. 29. Myoma in the Upper Part of Broad Ligament, and 30. Myoma in the Broad Ligament Proper.—When the tumordevelops on either side of the uterus, within the layers of the broad ligament, asit grows it separates the anterior from the posterior layer, raises thera up in
. Operative gynecology. it, as it were, from its peritoneal doing this and then cutting through the peritoneum reflected from thebowel onto the tumor, it may be from beneath instead of from above, the rec-tum at once drops into its normal position in the pelvis. The operation maythen be completed in the ordinary way. 29. Myoma in the Upper Part of Broad Ligament, and 30. Myoma in the Broad Ligament Proper.—When the tumordevelops on either side of the uterus, within the layers of the broad ligament, asit grows it separates the anterior from the posterior layer, raises thera up intothe abdomen, and pushes the body of the uterus to the opposite side. Theamount of disturbance of the normal topographical relations caused by such a 394 MYOMECTOMY—HYSTERO-MYOMECTOMY. tumor will depend upon its location in the broad ligament. When situated highup, the only effect may be to separate widely the three structures which lieclose together at the cornu uteri, the tube, the round ligament, and the COMPLICATIONS OF HYSTERO-MTOMECTOMT. 395 whicli are then found spread apart on the surface of the tumor, as shown inFig. 611. When the tumor grows farther down in the broad hgament, in addition toparting the round ligament from the tube and the ovary, it also displaces theovarian vessels at the brim, the sigmoid and the rectum, and the uterine vesselsand often also the bladder. This complication will be recognized by the dis-placement of these structiu-es. The treatment of such a mass on the left side is to begin the enucleation byfreeing the sigmoid enough to get at and tie and sever the ovarian vessels, andthen to tie and cut the round ligament, and to connect these two incisions byjust cutting through the peritoneum, which is pushed down toward the pelvicbrim. On grasping the tumor and pulling it to the right it is stripped out ofits cellular bed and the uterine vessels brought into view in the angle in front,between the tumor and the body of the uterus, wher
Size: 1282px × 1949px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
