File:Treatise on gynaecology - medical and surgical (1894) (14778343914).jpg

Identifier: treatiseongynaec02pozz (find matches)
Title: Treatise on gynaecology : medical and surgical
Year: 1894 (1890s)
Authors: Pozzi, Samuel, 1846-1918 Wells, B. H., tr
Subjects: Gynecology Generative organs, Female Women Gynecology Genital Diseases, Female Gynecologic Surgical Procedures
Publisher: New York : William Wood & Co.
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ure, used a catchforceps having a right-angled extremity. This seized the two endsof the wire at the same time that they were made to engage in thegroove of a long-handled shield (Fig. 84). The shield was j^ushedby the left hand along the wire in contact with the mucous mem-brane ; torsion was then effected by rotating the forceps upon its axis. CICATEICIAL FISTUL.E OF THE VAGINA. 317 Before removing the shield, he turned the wire in tlie direction ofthe vaginal outlet so that its ends should not wound the posteriorwall. Sims placed in the bladder a self-retaining permanent sigmoidcatheter of his own invention. Bozeman brings the margins of thewound together by a special instrument called a suture-adjuster. Itconsists of a long steel shank carrying a little flat disk pierced by ahole in its centre (Fig. S5), • Through this hole he iDasses the twoends of a suture; with these in the left hand he slides the disk doAvnto the wound in such a way as to secure its perfect coaptation and to
Text Appearing After Image:
Fig. 84.—Operation for Vesico-vaginal Fistula. Sims twister and shield. give to the wire a circular position, when it has only to be secured.Before the operation he prepares two or three small strips of lead, amillimetre in thickness and of a size adapted to the extent and formof the closed wound and hollowed out in the centre so as not to pressupon its lips. He then pierces the leaden plate, punching in it holesto the number of his sutures, passing through each hole the two ex-tremities of each separate suture, and then, bringing the plate intoclose contact with the vaginal wall, adjusts it with a special hook. Heencloses the wires with the lead somewhat after the manner in whichrubber tubing is used. Sims catheter is left in the bladder. The 318 CLINICAL AND OPERATIVE GYNyECOLOGY. sutures are removed on about tlie tenth, day, the patient being in thegenu-pectoral position as for operation, Le Fort places two rows of sutures—deep and superficial. The firstis entered at the intern

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