Gynecology . 325. until the cervical tissue is entirely severed. The uterus is now held only by theright uterine vessels (Fig. 323). They are clamped and cut so as to leave a longpedicle beyond the clamp. With the removal of the uterus and appendages onlytwo clamps remain in the pelvis controlling the uterine vessels. A third, toothed,clamp is now attached to the posterior lip of the cervical stump for the purposeof traction. If there is any question about the possibility of infection from HYSTERECTOMY OPERATIONS 617 the cervical canal, it may be cauterized or treated with crude carbolic acid
Gynecology . 325. until the cervical tissue is entirely severed. The uterus is now held only by theright uterine vessels (Fig. 323). They are clamped and cut so as to leave a longpedicle beyond the clamp. With the removal of the uterus and appendages onlytwo clamps remain in the pelvis controlling the uterine vessels. A third, toothed,clamp is now attached to the posterior lip of the cervical stump for the purposeof traction. If there is any question about the possibility of infection from HYSTERECTOMY OPERATIONS 617 the cervical canal, it may be cauterized or treated with crude carbolic acid oralcohol or iodin. The lips of the cervical stump are united with two or three interrupted suturesand then the uterine vessels are tied. The technic of tying these vessels is im-portant. While amputating the uterus pains were taken to leave the pediclesof the vessels extending beyond the clamps as long as possible. Beginning nowon the right, the redundant pedicle of the vessels is included in another pair of. Fig. 322.—Supravaginal Hysterectomy. Second Step of vessels of the left side have been severed and the uterus is being amputated by a wedge-shaped clamps to act as a sort of secondary defense. A ligature is introduced witha full-curved needle first into the tissue of the cervix inside the vessels, thenaround the vessels and tied. As the knot is tied the first or lower clamp isreleased. The ligature is then passed again in the same manner, and when tiedthe secondary clamp is removed. In this manner the uterine vessels are tiedtwice. By using the secondary clamp no blood is lost. The same procedureis carried out on the left. 618 GYNECOLOGY The next step, and a most important one, is the suspension of the cervicalstump by the broad ligaments in order to avoid a later prolapse, a complication
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