The assurance and skill which an operator acquires by following in any one condition a certain method of operation and technic might be commended, provided all his cases approach an ideal. However, this is far from any one's experience.
The popularity of the vaginal route for hysterectomy which is steadily growing among American surgeons has not reached its height with me. However, I do find in certain cases the method to be, if not ideal, at least expedient. I refer particularly to those cases in which excessive deposits of adipose tissue throughout the body are a sure indication of lowered vitality and lessened power of resistance to shock and to sepsis.
My early experience with this class of cases was very unhappy, and I have welcomed the simplification of the technic of vaginal hysterectomy by a bi-section of the uterus as a fortunate advance in modern surgery.
HUMISTON WH. THE ADVANTAGES OF THE VAGINAL OPERATION IN OBESE PATIENTS.. JAMA. 1902;XXXIX(11):626–627. doi:10.1001/jama.1902.52480370034001j
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