. Operative gynecology. -ureterostomy), and the patient recovered. Another time I discovered that I had tied a ureter by cutting a longitudinalslit in it (ureterotomy) and ninning in a sound. It was stopped by the ligature,which I at once took ofE, and no harm resulted. I show in Fig. 513 a diagram of a myomatous uterus weighing 23^ poimds,where both ureters were lifted higli up and out of the pelvis; the right ureterwas kinked in two places and raised 6 centimeters above the brim, while the leftureter was arched high up to a point 10 centimeters above the pelvic brim. Thecardinal principle in
. Operative gynecology. -ureterostomy), and the patient recovered. Another time I discovered that I had tied a ureter by cutting a longitudinalslit in it (ureterotomy) and ninning in a sound. It was stopped by the ligature,which I at once took ofE, and no harm resulted. I show in Fig. 513 a diagram of a myomatous uterus weighing 23^ poimds,where both ureters were lifted higli up and out of the pelvis; the right ureterwas kinked in two places and raised 6 centimeters above the brim, while the leftureter was arched high up to a point 10 centimeters above the pelvic brim. Thecardinal principle in treating this complication is to keep as close as possible to COMPLICATIONS OF HTSTEEO-MTOMECTOMY. 399 the uterus throughout the enucleation; this is done, after tying the left ovarianvessels and left round hgament and freeing the vesical peritoneum, by pushingdown the peritoneum on the left side and picking up the uterine vessels close tothe tumor, or by catching the artery by itseK in the cellular tissue; in this way. Topof blaJd Opening of ureterC-rvix Fig 514—CoMPLICiTED n\STEEO MiOMEOTOM^ The pelvic peritoneum is displaced high up into the abdomen by the enormous myomatous uterus, asindicated by the line beginning above the bladder and extending up to the round ligament, the oviduct, andending above the sacral promontory. The fundus lies above and on top of the uterus; above the umbilicuslies the sigmoid flexure, seen in cross section. The bladder lies -wholly in the abdomen, and both uretersare displaced above the pelvic brim; the left is indicated in dotted outline. The pelvis is also choked by thetumor, and the cervix lies near the level of the superior strait behind the symphysis. the ureter goes down at the side and drops into its normal place. The rightureter is in less danger, as in rolling the tumors up and out it is simply peeledofE, and remains behind with the peritoneum which had covered the tumor. Inthis way the complication is
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
