. Gynecology : . ch. A longitudinal incision about 5 cm. long is made, beginning at theportio and running back in the median line. The incision is carried through thevaginal wall, the loose cellular tissue, and into the peritoneal cavity. In orderto enlarge the opening thus made, two lateral cuts may be made at right anglesto the original incision (Fig. 330). To deliver the uterus and adnexa the poste-rior wall of the uterus is seized with double hooks and drawn backward out ofthe vaginal wound. OPERATIONS FOR UTERINE MALPOSITION Operations for Retroversion olshausens operation for suspension
. Gynecology : . ch. A longitudinal incision about 5 cm. long is made, beginning at theportio and running back in the median line. The incision is carried through thevaginal wall, the loose cellular tissue, and into the peritoneal cavity. In orderto enlarge the opening thus made, two lateral cuts may be made at right anglesto the original incision (Fig. 330). To deliver the uterus and adnexa the poste-rior wall of the uterus is seized with double hooks and drawn backward out ofthe vaginal wound. OPERATIONS FOR UTERINE MALPOSITION Operations for Retroversion olshausens operation for suspension of the uterus (authors TECHNIC) A short median suprapubic incision is made. The appendix is inspectedand removed as a routine measure. The edges of the peritoneum and fascia oneach side of the wound are clamped in order to facilitate the passage of round ligament is grasped near the uterus with a half-length clamp, whichis pressed tightly enough to raise the ligament, but not to lacerate it. A liga-. Fig. 331.—Olshausexs Operation-. First Step. The round ligament is lightly grasped with half-length forceps near the fundus. The silk suture is introduced so as to include the whole thickness of the ligament. ture of Xo. 7 braided silk doubled is then passed under the .right round ligamentat a distance from the uterus which is determined by the size, weight, desirefor mobility, etc., it being remembered that the nearer the uterus it is placedthe greater will be the supporting power and the less the mobility. Theaverage distance is \ inch. The suture is carried through the abdominal wall,including the peritoneum, muscle, and fascia, and then returned to the perito-neal cavity, including a bight in the wall of about \ to \ inch. The ligature isplaced in the abdominal wall at a distance from the median line correspondingto the point where the base of the round ligament would touch the peritoneumif the uterus were brought up to the abdominal wall. The level at which it
Size: 2123px × 1177px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdec, booksubjectgynecology, booksubjectwomen
