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The operation consists in shortening the round ligament through the vagina. The technic of the operation in uncomplicated cases is as follows: After the necessary antiseptic precautions, the patient is placed in the exaggerated lithotomy position. (A curettement is performed, when indicated.) The limbs are supported, retractors used, and the cervix uteri is seized with bullet forceps and drawn down, as in vaginal hysterectomy. With a scalpel, a transverse incision about one and one-half inches long is made at the anterior utero-vaginal junction, down to the uterus. Now with the index finger or with blunt pointed scissors, the uterus is separated from the bladder. The vesico-uterine space (anterior cul-de-sac), or rather the peritoneum lining it, is reached with ease. The peritoneum is seized with two anatomic forceps and opened between them with the scissors. The incision is then extended transversely about an inch each way. Now while still holding to
HOSMER AJ. E. WERTHEIM'S NEW METHOD OF RESTORING RETRODEVIATIONS OF THE UTERUS THROUGH THE VAGINA. JAMA. 1896;XXVII(11):595–596. doi:10.1001/jama.1896.02430890033002j
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