The practice of surgery . Fig. 181.—Uterine polyp removed -u-ith scissors. the patient in the Trendelenburg position; wall off the uterus; pull itto the fore with vulsellum forceps, and enucleate the tumors individuallywith knife, scissors, and fingers. In properly selected cases the opera- 300 FEMALE OKGAXS OF GENERATION tion is cxtrcMnely easy, aiul the hemorrhagic into the resultin<;- cavitiesis readily couti-ollcd by buried catgut stitches. Finally, sew iij) thewound in the uterus and suspend the organ if it seems inclined to dropback into an abnormal position, ^^ipe out the peritoneal
The practice of surgery . Fig. 181.—Uterine polyp removed -u-ith scissors. the patient in the Trendelenburg position; wall off the uterus; pull itto the fore with vulsellum forceps, and enucleate the tumors individuallywith knife, scissors, and fingers. In properly selected cases the opera- 300 FEMALE OKGAXS OF GENERATION tion is cxtrcMnely easy, aiul the hemorrhagic into the resultin<;- cavitiesis readily couti-ollcd by buried catgut stitches. Finally, sew iij) thewound in the uterus and suspend the organ if it seems inclined to dropback into an abnormal position, ^^ipe out the peritoneal cavity; re-place the omentum, and close the abdominal wound. It often requiressome nice surgical judgment to decide between myomectomy andhysterectomy. In general terms, myomectomy is preferable in casethe nuiss of tumors be of moderate size, and the growths located mostlynear the surface of the organ. Myomectomy for submucous polypi maywell be done by the abdominal route. The operation consists in splitting. Fig. 182.—Ligation of uterine vessels, clamp applied (adapted from Dudley). open the body of the uterus, cleaning out the submucous growths, andtreating the inflamed mucosa with the curet and weak carbolic applica-tions. Then sew up the uterus with catgut stitches, which shall notinclude the mucosa. This operation is eas}^ safe, and extremely effec-tive—a great advance over many old-time dilatings and cervical ])olypi may be removed with scissors or the wire snare. Supravaginal hiisteredoniy is the operation of common choice in casesof myoma uteri, and usually it is not difficult. Aolumes have beenwritten on the technic, and most of our best-known surgeons and gyne-cologists have had their word to say on the matter. AVhen all is said,the operation is simple enough when the pelvic conditions are uncom- TUMORS OF THE ITKIIUS 301 plicated. The abdomen is opened through the left rectus muscle by aliberal incision, large enough to permit of the delivery of t
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1910
