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

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mbs of the H that is in the sulci. This I believe is acorrect inference, and I prefer, therefore, a bilaterally symmetrical opera-tion extending up both sulci, based on the procedure of Dr. T. A. Emmet, ofNew York. 298 RUPTURE OF RECTO-VAGINAL SEPTUM AND RELAXED VAGINAL OUTLET. It is necessary to exaggerate slightly the effect of the operation in narrow-ing the vagina in order to counterbalance a slight relaxation which always fol-lows. The first step is to determine the limits of the denudation; this is done bymeans of two tenacnla shaped like a shepherds crook, fixed on either side at thejunction of the hymeneal ring, or its remains, leaving sufficient tissue acrossthe anterior vaginal wall between the tenacnla to make a small outlet when the tenacnla are brought together.These points mark the upper laterallimits of the resection. If they arefixed too near the urethra too muchtissue will be removed and the newoutlet will be too contracted; on theother hand, if they are fixed too low
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Fig. 172. — Relaxed Vaginal Outlet in aVII-para, with Perfect Preservation of.the Hymen, except in the Median LinePosteriorly. , ■ Forceps, were not- used.in any of the labors.Operation, June 1, 1897.

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