File:Gynecology - (1918) (14793403263).jpg

Identifier: gynecologygrav (find matches)
Title: Gynecology :
Year: 1918 (1910s)
Authors: Graves, William Phillips, 1870-1933
Subjects: Gynecology Genital Diseases, Female Women Gynecology
Publisher: Philadelphia : Saunders
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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Text Appearing Before Image:
Vl^.Gr—• Fig. 259.—Anterior Colpgplasty (ClarksTechnic).The mattress sutures have been tied. Theexcess of vaginal mucous membrane is beingtrimmed away.
Text Appearing After Image:
\\O.0rr-* Fig. 260.—Anterior Colpoplasty (Clarks Technic). The vaginal wound is closed with interrupted catgut sutures. and crossing the urethra near its junction with the bladder (Fig. 257). The endsof the sutures are clamped and not tied until all the external sutures are placed.The next step in the operation is to implicate the hernial protrusion of thebladder by a continuous No. 1 catgut suture. Clarks method of employing theCushing stitch is an excellent one. In applying the implicating stitch it shouldbe carried well out on the sides of the protruding bladder and include the aponeu-rotic investiture mentioned above, for it is on this fascial support that the final 620 GYNECOLOGY success of the operation largely depends. When the implicating stitch has beenapplied it will be found that there usually exists a greater or less excess of vaginalmembrane. This excess of membrane is then trimmed off. The amount ofmembrane to be removed requires good judgment. Care must be taken notto

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