File:Gynaecology for students and practitioners (1916) (14595430607).jpg

Identifier: gynaecologyforst00eden (find matches)
Title: Gynaecology for students and practitioners
Year: 1916 (1910s)
Authors: Eden, Thomas Watts, 1864-
Subjects: Gynecology Gynecology
Publisher: New York : Macmillan
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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Text Appearing Before Image:
Fig. 508. Excision of Vulva and Inguinal GlandsVulvo-Vaginal Cancer. PERFORMED FOR both sides at the same time, whether they are palpable or not. Cancerwhich involves the vestibule often spreads across the mid-line (seeFig. 169, p. 356) ; it is also not infrequently multiple, appearing onboth sides simultaneously (see Fig. 167, p. 355) ; in such cases, there-fore, it becomes necessary to remove the glands from both groins.The operation proceeds as follows (see Figs. 508 and 509) : An incision through skin and superficial fascia is made above and PLASTIC OPERATIONS 839 parallel to Pouparts ligaments, and the fatty tissue of the groin,carrying the glands of both the inguinal and femoral groups, isdissected out en masse from without inwards. This is done on bothsides, the divided vessels being clamped and ligatured as the operationproceeds. The mass of glands and fat is not removed at this stage,
Text Appearing After Image:
Fig. 509. A. Opekation fok Cancer of the Clitoris. Dotted line shows incisions and the shaded area the parts to be removed. B. Operation for Vulvo-Vaginal Cancer. The incisions are represented by a dotted line. The shaded area shows the parts to be removed. but is wrapped in sterile gauze and removed in conjunction with thecancerous tissue later in the operation. After dissection of the glandsthe inguinal wounds are closed with interrupted fishing-gut suturesand covered with a sterilized towel. The position and extent of the vulval growth wiU determinethe subsequent steps of the operation. If the growth involves theclitoris and adjacent nymphse, as shown in Figures 167 and 169 (pp. 840 GYNECOLOGY 355 and 356), these structures are removed en masse. To do thisthe lower ends of the inguinal incisions are prolonged downwardsby cutting through the substance of the labia majora to a pointbeyond the lower extremity of the growth, keeping well outside thecancerous area. These lateral incisio

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