. Operative gynecology. thout tearing its structure, so I aban-doned the effoi-t in this direction and further opened up the broad ligament onthe left side, until the uterine vessels low down were exposed. I then workedthe finger out into the loose cellular tissue in the angle between the vagina,supravaginal cervix, and the bladder, and freed the bladder first at this point,and then continued to strip it loose from its attachments from below up-ward, reversing the ordinary procedure ; the rest of the enucleation was then 396 MYOMECTOMY—HYSTERO-MYOMECTOMY. easily completed. Care must be taken i
. Operative gynecology. thout tearing its structure, so I aban-doned the effoi-t in this direction and further opened up the broad ligament onthe left side, until the uterine vessels low down were exposed. I then workedthe finger out into the loose cellular tissue in the angle between the vagina,supravaginal cervix, and the bladder, and freed the bladder first at this point,and then continued to strip it loose from its attachments from below up-ward, reversing the ordinary procedure ; the rest of the enucleation was then 396 MYOMECTOMY—HYSTERO-MYOMECTOMY. easily completed. Care must be taken in following this method to keep closeto the uterus so as to avoid the ureter. 32. Myoma situated Postero-laterally.—The special point tobe noted in myomata developing postero-laterally is the tendency to elevatethe rectum and sigmoid flexure when the tumor is located on the left complication will be treated by dissecting off the bowel and ligating theovarian vessels of that side as already described Fig. 512.—Myomatous Uterus WEiGniNO 39 Pounds, seen from Behind. Showing the extreme distortion of the uterine body by the tumors occupying every conceivable point of amputation of the cervix is shown at C, and the right and left ovaries and tubes are seen aboveon either side. The left tube is lengthened out and displaced by a large intraligamentary mass. The lowerpart of the tumor, from a point above the cervix transversely across to the right, was entirely Kecovery. Longest diameter 39 centimeters. San. March 16,1895. J^ natural size. 33. Myomata situated under the Pelvic Peritoneum inSeveral of these Positions at Once.—I have enumerated above(Nos. 28-32) the various positions in which myomata may be found singly be-neath the pelvic peritoneum, and dwelt carefully on the special character of thedisplacements produced and their proper management at the operation; I nowwish to speak of a still more complicated
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
