File:Pathology and treatment of diseases of women (1912) (14778498151).jpg

Identifier: pathologytreatme00mart (find matches)
Title: Pathology and treatment of diseases of women
Year: 1912 (1910s)
Authors: Martin, August Eduard, 1847- Jung, Ph. (Philipp Jacob), 1870-1918
Subjects: Gynecology Gynecology
Publisher: New York : Rebman company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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t with the plica,detachment of the two halves of the uterus as far as their lateral connec-tion. These can be severed after strong clamps have been applied to theligament stumps. Then the incised lumina of the vessels in the ligamentsare attended to and after removal of the clamp forceps the stump is cov-ered by peritoneum. I prefer to ligate the ligamentum suspensoriumovarii and the pars cardinalis, in several small parts before cutting them. The surface of the incision is examined for hemorrhage, and thencovered by peritoneum. Closure as above. 2. Abdominal Myoma Operations For abdominal myoma operations different methods, conservative aswell as radical, may be chosen. Here also the choice can be made only after exposure of the uterus, PATHOLOGY OF THE VAGINA AND UTERUS 261 •indeed often only after enucleation of the myoma. Accordingly we pro-ceed so that we incise the abdominal wall in the median line or by atransverse incision after Pfannenstiel. The latter leads close above the
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Fig. 120.—The exposed uterus is split. The myoma pulled taut by a Muzeux forceps.Firm connections with the bed of the tumor are separated with the scissors. pubic folds deep down to the fascia of the musculus recti respectivelyobliqui. Incision and detachment of the fascia from the musculature,careful arrest of hemorrhage, incision of the linea alba as far as the 262 DISEASES OF WOMEN abdominal cavity. The myomatous uterus is brought out of the abdomi-nal wound. Lowering of the head part of the operating-table, protectionof the abdominal cavity by sterile gauze dressings. Exact inspection nowshows how much of the functionating tissue of the uterus remains, alsowhether the ovaries and tubes are healthy. (a) With sufficient functionable uterine tissue in solitary round myo-

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