Operative gynecology : . on for Vaginal Hysterectomy.—The removal of the entire uterus bythe vagina through the inferior pelvic strait has been the operation most fre-quently performed in the past for cancer of the cervix, or of the cervix and fundus together, or of the fun-dus alone. For the last three yearsmy own practice has been tolimit the indications for vagi-nal hysterectomy, choosing inpreference the more radicalenucleation through the abdo-men, for by the vagina onlythe uterus and little or none ofthe adjacent broad ligamentscan be removed, and so carci-nomatous tissue is often leftbe
Operative gynecology : . on for Vaginal Hysterectomy.—The removal of the entire uterus bythe vagina through the inferior pelvic strait has been the operation most fre-quently performed in the past for cancer of the cervix, or of the cervix and fundus together, or of the fun-dus alone. For the last three yearsmy own practice has been tolimit the indications for vagi-nal hysterectomy, choosing inpreference the more radicalenucleation through the abdo-men, for by the vagina onlythe uterus and little or none ofthe adjacent broad ligamentscan be removed, and so carci-nomatous tissue is often leftbehind which might have beenremoved by a more careful dis-section from above. Vaginal hysterectomy isstill indicated in fat women,whose thick abdominal wallsform an almost insuperableobstacle to a complete opera-tion from above. It is not be-cause the difficulty in remov-ing the uterus by the abdominal method is so great in these cases, but thefact that a wide exsection of the broad ligaments and removal of the pelvic602. Fig. 340.—Vegetating Epithelioma of the Cervix. PREPARATION OF THE PATIENT. 603 glands is almost impossible, on account of the mechanical hindrances offeredby the thick Avails and the deep pelvis. Preparation of the Patient.—The patient must be duly prepared by rest,baths, vaginal douches, and above all by a thorough evacuation of the bowels.
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
