Essays on hysterectomy / by J. Bland-Sutton.

  • Sir John Bland-Sutton, 1st Baronet
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Essays on hysterectomy / by J. Bland-Sutton. Source: Wellcome Collection.

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    and straightforward operation the floor of the pelvis should only show a narrow ridge in the line of suture. The pelvis is cleared of blood and dabs; the intestines fall in their places and the omentum is spread over them. The dabs and forceps are counted to ensure that none is left in the belly. The incision is then sutured in layers; the peritoneal edges are joined with a continuous layer of very fine silk : the muscles and fascia with inter¬ rupted sutures of silk-worm gut, and the skin with a continuous suture of fine silk. The chief advantage among many of this method of suturing the incision is, that it has almost abolished the occurrence of post¬ operative hernia and the routine use of an abdominal belt. The patient is restored to the horizontal position; any blood and clot that may have escaped into the vagina is carefully removed with gauze dabs; the bladder is emptied by means of a glass catheter. The wound is dressed with a piece of moist cyanide gauze, covered with sterilised Gramgee tissue retained by a many-tailed flannel bandage. The details of the operation set forth in this account refer to a simple or uncomplicated hysterectomy, and under these conditions it cannot be described as a difficult operation to any surgeon accustomed to dealing surgically with the abdomen, but the complications not infrequently met with in connection with uterine fibroids are occasion¬ ally very formidable and tax the skill and resource of the boldest, e. g. : Large incarcerated cervix fibroids complicated with a big fibroid in the fundus. Fibroids with extensive adhesions to rectum, colon, or small intestine. Large fibroids of the cervix displacing the bladder. Fibroids associated with suppurating ovarian dermoids, or pyosalpinx. Perhaps the most dangerous condition is the co-ex-
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