USPENSION AND VENTRO-

ation for fixing the uterus, by means of

gical operation for displacements of the uteru

he uterus; when carried out for prolapse it is termed ventro-fixation of the uterus. When care is taken

N FOR RETROFLEXI

instruments required as those used

that the incision is shorter; the operator then determines with his fingers the position and condition of the body

tumour in the ovary, such as a small dermoid, but more often the body of the uterus is drawn backwards by a small fibroid in the fundus of the organ. In these conditions an operation embarked upon as a simple hysteropexy may become an o?phorectomy,

o the abdominal wall

oneurosis on the opposite edge of the incision; 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 edges of the wound. Two sutures should be introduced. In patients who have had children

N FOR PROLAPSE

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, in order that the assistant may use it as a tether

refore in close relation to the bladder. It facilitates the operation to introduce the lowest sutures firs

conducted on the same l

tion that it should have no mortality. At the Chelsea Hospital for Women, from 1904 to 1906, both ye

A wide study of operation returns show that hysteropexy is not absolutely free from risk

from the fundus as a result of hysteropexy performed nearly

us is small, there is, in many instances, a strain on the sutures. The effect of this strain is twofold. When the uterus is attached to the abdominal wall by an aseptic suture, lymph is exuded from the surfaces of the peritoneum in contact with the retaining sutures. This effused lymph organizes into a tenacious tissue, and the strain of the uterus, when the oper

ough one or more pregnancies successfully without disturbing the union, or even stretching it. This I have proved in twelve instances where some subsequent trouble such as appe

and was sent to me on this account. I found the sigmoid flexure of the colon caught in one of the sutures, which accounted for some of the woman's trouble, but the uterus was so firmly fixed to the abdominal wall and had been so dragged upon that

ere

phy. American Journal of

ei Prolapsus und Retroversio Uteri. Cen