Operative gynecology : . 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 Fig. 341.—Epithelioma of the Cervix without Vegetation. The vaginal vault is converted into a flat granulating surface. The cervical opening is seen inthe center. If the cancerous disease has advanced to the sloughing stage, or s
Operative gynecology : . 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 Fig. 341.—Epithelioma of the Cervix without Vegetation. The vaginal vault is converted into a flat granulating surface. The cervical opening is seen inthe center. If the cancerous disease has advanced to the sloughing stage, or so far asto cause any odorous discharges, or to form a mass protruding into the uppervagina, the danger of sepsis will be greatly increased unless the field is first 604 VAGINAL HYSTERECTOMY. cleansed by a thorough curettage, removing as much of the diseased tissue ascan be scraped away with a sharp curette (see Chap. XX). If the vagina ispacked every two days after doing this, in a week or ten days the patient willbe ready for the radical operation. In an urgent case the curettage may bedone just before the uterus is removed. Operation.—The patient is brought to the edge of the table in the lithotomyposition, with the limbs well flexed and the buttocks resting on the perineal pad.
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