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, 1910

} New Series, Vol. V., No. 3.

xvi. 125 in the peritoneal cavity, and after four fixa- ceps is pulled down toward the vulva. A tion sutures have been passed through the transverse incision is made through the


FIG. 4. vaginal flaps and through the uterine wall, posterior wall of the cervix and the lower the cervix grasped with a volsellum for- lip of the incision is grasped with two long artery forceps as shown in Figure 3. The cision on the posterior cervix wall, and the finger covered with gauze dissects the low- index finger or the thumb, covered with er lip of the incision away from the pos- gauze, pushes up this vaginal mucosa and teror wall of the cervix up to and beyond separates it from the cervix up to the sitthe peritoneal fold of Douglas. Fig. 4. The uation of the uterine arteries, as is shown cervix is then pulled out and to one side ; a

in Figure 5.

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then united about the internal os. Chromic longitudinal incision almost into apposition
catgut sutures Nos. 3 or 4 are passed when tied as shown in Figure 9.
through the cervical canal through the en- The remaining area of the lateral walls
tire wall of the cervix and out of the cervix may then be closed or covered
through the vaginal mucosa. The first in either of two ways; either by passing

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the failure to resect parts of the anterior passed through the vaginal flaps as was vaginal flaps is evident. The method which done in Figure 3 but are simply allowed to


FIG. 8. best overcomes this disadvantage is the pass out through the vagina and are to be following:

held by artery forceps for subsequent use. Fixation sutures are passed through the The attaching of the vaginal mucosa to the anterior wall of the uterus but are not cervix is begun as in Fig. 7 by three sutures

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