. Operative gynecology. AND TUBES. There is often found a false line of apparent reflection of the vesical perito-neum high up on the fundus formed by peritoneal adhesions; when this is dis-sected away from the uterus the real line of reflection is evident. I now detach the vesical peritoneum along this line, beginning at the leftround ligament and continuing the incision in a concave line down across thefront of the uterus around to the riglit round ligament. Then, grasping uterus,ovary, and tube in the left hand, or with museau forceps, I draw them stronglyupward, outward, and toward the opp
. Operative gynecology. AND TUBES. There is often found a false line of apparent reflection of the vesical perito-neum high up on the fundus formed by peritoneal adhesions; when this is dis-sected away from the uterus the real line of reflection is evident. I now detach the vesical peritoneum along this line, beginning at the leftround ligament and continuing the incision in a concave line down across thefront of the uterus around to the riglit round ligament. Then, grasping uterus,ovary, and tube in the left hand, or with museau forceps, I draw them stronglyupward, outward, and toward the opposite side, while with the right hand Ipush the vesical peritoneum down oif the cervix with a firm sponge held in apair of forceps. The force of the push and peeling movement with the spongemust fall upon the uterus and not en the bladder. The separation of the blad-der from the cervix is easily effected in this way, exposing the uterine arteriesand veins low down in the angle between vagina and cervix. After baring the. Fio. 395.—Extirpation of , Tubes, anii Ovaries for Pelvic Peritonitis. The right ovary contains two small Graafian follicle cysts. The left tube and OTary are converted intoa ragged mass by the adhesions. ^ natural size. cervix for about 3 centimeters I take it up between the thumb and the fore-finger in front and behind and seek out its lower end, which can be readily dis-tinguished through the vaginal vault. In the same way, palpating at the side ofthe cervix, I easily recognize the uterine artery by its pulsations. This I nowligate by a medium-sized silk suture, carried beneath the vessels from lieforebackward, low down and close to the cervix. Having now placed allthe uterine vessels on the left side under control, I proceed to amputate thecervix with a hysterectomy spud or a sharp scalpel, cupping it slightly andangling the cut off on the right side to a little higher level. While this is being done the uterus is drawn strongly upward, grasped by
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
