File:Gynecology - (1918) (14586963179).jpg

Identifier: gynecologygrav (find matches)
Title: Gynecology :
Year: 1918 (1910s)
Authors: Graves, William Phillips, 1870-1933
Subjects: Gynecology Genital Diseases, Female Women Gynecology
Publisher: Philadelphia : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ing the operation of supra-vaginal hysterectomy is as follows: After the cervical stump has been closed and the uterine vessels have beentied, an assistant introduces into the vagina a long curved clamp with the tipturned toward the abdominal wound (Fig. 384). As the introduction of theclamp must be made under the operating sheet covering the patient, the assist- 724 GYNECOLOGY ant must be careful not to enter the urethra instead of the vagina. The stumpof the cervix is drawn strongly upward and the ends of the clamps are pressedagainst the posterior vaginal wall near the cervix. The clamp is then unclaspedand the surgeon makes an incision between the ends of the clamp through thevaginal wall (Fig. 384). The assistant closes the clamp, forces it through thevaginal opening into the posterior culdesac and receives a cigarette-drain, whichhe draws down into the vagina (Fig. 386). The rest of the operation is thencompleted and the abdominal wound closed. In most cases the drain is removed
Text Appearing After Image:
\i;pGw>ts.^vS Fig. 3&o.—Vaginal Drainage After Supravaginal Hysterectomy.A cigarette drain is being passed by the surgeon to a clamp, which has penetrated an opening made in the posterior vaginal wall. in two or three days and does not have to be replaced. By this method of drain-ing the pelvis the time of convalescence of the patient is not lengthened beyondthat of cases where drainage is not required. COMPLETE HYSTERECTOMY Except for malignant disease, complete hysterectomy, which implies anextirpation of the cervix together with the uterine body, is seldom necessary.There are, however, certain conditions which make the removal of the cervixdesirable, conditions that sometimes cannot be foreseen before the abdomen is HYSTERECTOMY OPERATIONS 725 opened for operation.- On account of the possibility of indication for completehysterectomy, and consequent exposure of the vaginal mucous membrane, thevagina should always be thoroughly prepared before a pelvic operation whichby any

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