. The Principles and practice of gynecology : for students and practitioners. 640 DISPLA CEMENTS. hernia by denuding the protrusion of its surface epithelium, invagi-natiug it, and sewing the surfaces together. On the contrary, we areaccustomed to treat other hernias by reducing them and excisingthe sac until we lay bare strong, firmly attached fascial edges.^Such should be the treatment of cystocele. The principle set forth by Reynolds in the above quotation has ledme to abandon my previous operation of lateral elytrorrhaphy and tosubstitute an operation of which the steps are the following:
. The Principles and practice of gynecology : for students and practitioners. 640 DISPLA CEMENTS. hernia by denuding the protrusion of its surface epithelium, invagi-natiug it, and sewing the surfaces together. On the contrary, we areaccustomed to treat other hernias by reducing them and excisingthe sac until we lay bare strong, firmly attached fascial edges.^Such should be the treatment of cystocele. The principle set forth by Reynolds in the above quotation has ledme to abandon my previous operation of lateral elytrorrhaphy and tosubstitute an operation of which the steps are the following: First Step.—To split the anterior vaginal Avail—that is, thevaginal plate of the vesicovaginal septum—by means of scissors, from FiGUKE 358. Figure Figure 358.—The redundant puriion of the vaginal wall having been removed, the incisionsare extended to the sides of the uterus, and that portion of the vaginal wall lying in the marginof the wound, here shown by dotted lines, has been cut away, not by superficial denudation,but by deep incisions, so thatthe whole thickness of the vaginal wall has been removed, expos-ing the broad ligaments or the structures in direct connection with them. At points a and &are shown the first two sutures as they should be passed for the purpose of bringing the struct-ures, in the neighborhood of the broad ligaments, together in front of the cervix uteri, so as toforce the cervix bacli into the hollow of the sacrum, and to give it firm support. The dottedlines show that portion of each suture which is buried beneath the exposed surfaces. Figure 359.—Same as Figure 358, except the two sutures, a and b, are tied in front of the cer-vix and the cervix is forced back into its normal location. The n
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectgynecology, bookyear1
