Operative gynecology - (1906) (14597025737)

Identifier: operativegynecol001kell (find matches)

Title: Operative gynecology :

Year: 1906 (1900s)

Authors: Kelly, Howard A. (Howard Atwood), 1858-1943

Subjects: Gynecology Gynecology Gynecologic Surgical Procedures

Publisher: New York and London : D. Appleton and company

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

Relaxed Vaginal Outlet. Shepherds-crook tenacula fixed in both sidesjust within the hymen, mark the limits of the de-nudation. The tenacula are crossed to show thesize to which it is proposed to reduce the recon-structed outlet. down, the new outlet will continue to be too large, notwithstanding the opera-tion. The. correct, pattern to have in mind in resecting is the nnlliparonsoutlet. OPERATION FOE RELAXED VAGINAL OUTLET. 299 A third tenaculum is now fixed in the vagina in the median line posteriorly,on the crest of the vaulted prominence of the rectocele, or posterior column(see Fig. 174). With these three points fixed, the area of denudation must now be out-lined with a sharp scalpel. The bloody outline obviates the liability to error

Text Appearing After Image:

H. ^ec/ters^ Fig. 174.—Relaxed Vaginal Olttlet.Showing the shepherds-crook tenacula fixed at the sides, below the urethra, and the tenaculumforceps drawing the posterior columna downward, so as to expose the lateral vaginal walls where thetriangular denudations are made. in a free-hand denudation. No one pattern will fit all cases; as an excessiverelaxation requires a more extensive resection than one of moderate degree. The surface to be denuded is irregular in outline and occupies several planes,making it difficult to represent it adequately in a picture. In making the out- 300 RUPTURE OF RECTOVAGINAL SEPTUM AND RELAXED VAGINAL OUTLET. line the central tenaculum and one of the lateral tenacula are drawn widelyapart, downward, and outward, exposing one of the vaginal sulci. there be a moderate degree of

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1906

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