Puerperal hysterectomy, or, Porro's operation by a new method / by H. Widenham Maunsell.

  • Maunsell, H. Widenham, 1845-1895.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Puerperal hysterectomy, or, Porro's operation by a new method / by H. Widenham Maunsell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    PUEKPEEAL HYSTEKECTOMY; OE POEEO’S OPEEATION BY A NEW METHOD. By H. WIDENHAM MAUNSELL, M.t)., Honorary Surgeon, Dunedin Hospital; Lecturer on Surgery in the Otago Unioersity. PoKRO, of Pavia, was the first surgeon who successfully amputated the preg- nant uterus in a woman—utero-ovarian amputation as a mode of completing CiEsarean section. The operation was performed twelve years ago in the Maternity Hospital of Pavia, on a woman deformed by rickets. Since then the operation has been perfoi’ined 200 times, with a mortality of nearly 50 per cent. Instruments required.—Strong scalpel, large strong circular amputating knife, two pairs of strong scissors, eighteen pairs of Spencer Wells’ artery forceps, two strong slightly-curved needles, on handles; curved surgical needles, suitable sutures and ligatures, specially prepared; yard of strong rubber tubing, for tourniquet; Tait’s recent modification of Koeberle’s serre- noeud, with needle for transfixing pedicle ; three large flat sponges, the bi- chloride antiseptic solution, and large quantities of hot water. In performing laparotomy in the median line, the incision should be lower than for simple Ciesarean section, as the stump of the amputated uterus has to be brought out immediately above the pubes, as in hysterec- tomy. A sound should be passed into the bladder, and every care taken not to injure it, as it is often dragged up above the pubes in these cases. New Method of Treating the Stump. 1. The incision should be long enough to permit of the gravid uterus being taken out of the cavity of the abdomen. 2. While an assistant takes charge of tlie gravid uterus, place a large flat sponge, wrung out of hot water, over the bowels, to keep them warm and out of sight; and rapidly suture up the wound with strong salmon silkworm gut, as far as the neck of the uterus, which is pressed towards the pubic end of the wound by an assistant. 3. Open uterus by longitudinal incision in upper third, and remove child, leaving placenta behind.