Abdominal surgery . ppeared in the journals. Richelot ofParis, in particular, has devoted attention tothe method with conspicuous and Landau strongly recommendthe method, and many other operatorsspeak favourably of it. I have forsome time advocated this principle,and had devised a special clamp forthe practical carrying of it out, sometime before it was mentioned in thejournals. The instrument (Fig. 35) is simply astraight clamp with long and powerfulhandles, and grooves on its lateral as-pect to guide a small knife which isintended to cut through the clampedligaments. It is de
Abdominal surgery . ppeared in the journals. Richelot ofParis, in particular, has devoted attention tothe method with conspicuous and Landau strongly recommendthe method, and many other operatorsspeak favourably of it. I have forsome time advocated this principle,and had devised a special clamp forthe practical carrying of it out, sometime before it was mentioned in thejournals. The instrument (Fig. 35) is simply astraight clamp with long and powerfulhandles, and grooves on its lateral as-pect to guide a small knife which isintended to cut through the clampedligaments. It is deeply slotted on itscompressing aspect,to prevent slipping;elsewhere it is smooth and the posterior opening the fore-finger is carried over the top of onebroad ligament, hooking it down asfar as possible. This manoeuvre may be facilitated by a blunt hook, handed over to an posterior blade is now carried upwards along the finger,at a distance of about half an inch from the uterus, and the. Fig. 35. The Authors Clamp for Kolpo-Hysterectomy. One-third size. FORCI-PRESSURE TO BROAD LIGAMENTS. 225 end hooked over the top of the Hgament. Its handle is pressedbackwards on the perineum. The anterior blade is intro-duced in front of the ligament, parallel to the posterior blade,and its end is locked by a simple mechanism into the endof the posterior blade. The clamp is then closed, and thehandles screwed up tightly outside the vulva. A second clampis similarly applied on the opposite ligament. When bothclamps are applied, the knife is run up the grooves and theligaments divided on the uterine side of the clamps, when theuterus is freed. Or scissors may be used for this division. Theinstruments may be easily removed at the end of one or twodays, when the natural process of vascular closure will provideagainst the occurrence of haemorrhage. Mr. Knowsley Thornton has devised a modification of thisclamp, in which the handles, attached by a bayonet joint, maybe r
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