Gynaecology for students and practitioners . Fig. 448. Martins Pelvic Trochae. the fluid has been effectively isolated by adhesions, it may be douchedwith a sterile saline solution to wash away blood-clot or purulent dOLPOTOMY 779 material. This should not be done in recent or acute cases, lestinfective material be carried upwards by the fluid into parts previouslyunaffected. Drainage may be provided for by loosely packing thecavity with gauze, or by introducing a rubber drainage-tube pro-vided with a flange to keep it in Fig. 449. Incision preparatory to Anterior Colpotomy and to S
Gynaecology for students and practitioners . Fig. 448. Martins Pelvic Trochae. the fluid has been effectively isolated by adhesions, it may be douchedwith a sterile saline solution to wash away blood-clot or purulent dOLPOTOMY 779 material. This should not be done in recent or acute cases, lestinfective material be carried upwards by the fluid into parts previouslyunaffected. Drainage may be provided for by loosely packing thecavity with gauze, or by introducing a rubber drainage-tube pro-vided with a flange to keep it in Fig. 449. Incision preparatory to Anterior Colpotomy and to SplittingTHE Cervix for the Removal of Submucous Fibroids. Anterior Colpotomy. In this procedure, the preliminary stepsof which are described on p. 789, a transverse incision is made acrossthe anterior fornix, just below the lower limit of the bladder [see ), which corresponds to the line where the rugose mucous mem-brane covering the bladder merges into the smooth mucosa coveringthe cervix. When there is any doubt in determining this line, thelimits of the bladder are defined with a sound. The incision is neces-sarily made much nearer the external os than in posterior colpotomy. rso GYNECOLOGY The bladder is then separated from the cervix by first putting theintervening connective tissue on the stretch and dividing it with blunt-pointed scissors directed towards the cervix {see Fig. 450). This is doneuntil the peritoneum is finally reached. It lies at a much deeperlevel than that of the posterior pouch. With the finge
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
