. Gynecology : . Fig. 261.—Amputation of Cervix and Anterior Colpoplasty (Studdiford). The vaginal mucous membrane over the cystocele has been incised and the vagina and bladder walls freely separated by blunt dissection. The cervix is being circumcised. should not be attempted by an inexperienced operator. The technic here de-scribed is in general that recommended by W. E. Studdiford. OPERATIONS ON THE VAGINA 621 The cervix is grasped with double hooks and drawn strongly outward anddownward so as to expose the entire cystocele. A median incision is madethrough the vaginal mucous membrane from
. Gynecology : . Fig. 261.—Amputation of Cervix and Anterior Colpoplasty (Studdiford). The vaginal mucous membrane over the cystocele has been incised and the vagina and bladder walls freely separated by blunt dissection. The cervix is being circumcised. should not be attempted by an inexperienced operator. The technic here de-scribed is in general that recommended by W. E. Studdiford. OPERATIONS ON THE VAGINA 621 The cervix is grasped with double hooks and drawn strongly outward anddownward so as to expose the entire cystocele. A median incision is madethrough the vaginal mucous membrane from a point \ or f inch belowthe meatus to the junction of the vagina with the portio vaginalis of thecervix. The plane of cleavage is found between the vaginal and bladder walls. YiP&iwita Fig. 262.—Amputation of Cervix and Anterior Colpoplasty (Studdiford).The bladder has been exposed and stripped back from the cervix. In the case from which thisdrawing was made the cardinal ligaments were exposed on the right. On the left they had been tornaway during the process that led to the condition of prolapse. and the vagina stripped away widely on each side of the central incision. It is ofimportance to carry this splitting of the two walls far out on the sides of thecystocele, and it should be especially thorough at the level of the neck of the blad-der. The cleavage of the two walls is accomplished by the gloved finger and withbkmt dissection. Many use gauze to hasten the dissection, but this technic addsmuch to the danger of rupturing the bladder wall. 622 GYNECOLOGY When the dissection of the surfaces has been completed the cervix is cir-cumcised at the point of junction of the vagina and portio. The vaginal flapsare seized in tenacula and drawn outward ar
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