The diseases of women : a handbook for students and practitioners / by J. Bland-Sutton and Arthur E. Giles.

  • Bland-Sutton John, Sir, 1855-1936.
Date:
1900
Catalogue details

Licence: In copyright

Credit: The diseases of women : a handbook for students and practitioners / by J. Bland-Sutton and Arthur E. Giles. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    When he finds it undesirable to interfere with the ovaries or tubes, then with a curved needle, armed with fishing-gut or silk, he first passes it through the peritoneum at the edge of the w'ound, then through the anterior surface of the uterus, and finally through the opposite peritoneal edge; when this suture is tightened, it will be found to draw the uterus to the anterior abdominal wall, and at the same time approximate the divided edges of the peritoneum. If desirable, two or more sutures may be introduced. The rest of the wound is then carefully closed in single, double or triple layers according to the habit of the operator. 2. Prolapse of the Uterus.—When hysteropexy is needed for a large, bulky and prolapsed uterus, the steps of the operation are the same as for retroflexion, but it is necessary to introduce a greater number of retaining sutures. Further, as the uterus tends to slip downward into the vagina, it is an advantage, as soon as the fundus of the uterus is drawn into the wound, to transfix it with a stout suture either of silk or fishing-gut, in order that the assistant may use it as a hold- fast to keep the uterus in position whilst the surgeon intro- duces the main sutures. In some cases, where the uterus is very large, it may be requisite to employ four, five or even six sutures to secure it to the abdominal wall. In all cases of hysteropexy the uterus is of necessity sutured to the lower angle of the wound, and is therefore in close relation to the bladder. It facilitates the operation to intro- duce the lowest sutures first and then gradually work up to the fundus. The wound is then closed and dressed as de- scribed for coeliotomy. ifter-trcatment.—This is conducted on exactly the same lines as after ovariotomy. The Risks.—When hysteropexy is performed by surgeons experienced in abdominal work it should have no mortality. In a small percentage of casee it has been followed by difliculties .llmnder's Lijaments-Iiii t apomg fe ron analtnilsIiKten liest OSes fo wffiiaitisiinco] Ittitramcntst ffintsreq ®*ps:sffisois;i ^ Of I, Kie S, KK k. \