File:Gynecology (1916) (14779687682).jpg

Identifier: gynecologygrav2 (find matches)
Title: Gynecology
Year: 1916 (1910s)
Authors: Graves, William Phillips, 1870-1933
Subjects: Gynecology Genital Diseases, Female Women Gynecology
Publisher: Philadelphia and London : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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depicted in Fig. 348.When the finger has been properly looped about the vessels the pulsation ofthe uterine artery can easily be felt. The vessels are then lifted away from theureter and freed as far as possible toward the pelvic wall. A double ligature ispassed and tied and the vessels cut between the two ligatures. The ureter andits point of entrance into the bladder are now freely exposed, and an oppor- 640 GYNECOLOGY tunity given for separating by blunt dissection the ureter and angle of thebladder from the lateral wall of the vagina. This procedure helps to carry outstill further step No. 3—i. e., the separation of the bladder from the vagina,which it was said was necessarily left incomplete. The isolation of the ureter, ligation of the uterine vessels, and separation ofthe ureter and bladder from the side of the vagina are repeated on the left side. ~^tx\.toYieum TEAabbexv XftRouni)^. Site, °^ C HCRoimb \> ig fffftoW: Uterine• ^ Vessels 3ft.l)ireter
Text Appearing After Image:
NA/.Pes. Fig. 346.—Wertheims Operation for Cancer of the Cervix.The broad ligaments have been tied and cut. The bladder has been dissected from the cervix.The right ureter is exposed. The forefinger is being introduced between the ureter and uterine ves-sels. The point of the forefinger is forced through the cellular tissue in front of the vessels. (5) Separation of the Rectum and Final Dissection of the Parametria! andParavaginal Tissue.—The uterus is now drawn strongly forward, exposing aswell as possible the pouch of Douglas. The peritoneum at the bottom of thispouch is picked up and cut, and the blunt-pointed scissors inserted beneath theperitoneum, as in separating the uterovesical reflection. The peritoneum is inthe same way cut across from broad ligament to broad ligament, exposing the HYSTERECTOMY OPERATIONS 641 uterosacral ligaments. Clamps are placed on the ligaments and the tissuesevered. On cutting these ligaments the uterus is noticeably released. Therec

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