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Abdominal hystero-myomectomy may be, supravaginal, in which the tumor, corpus uteri and supravaginal portion of the cervix are removed, or, complete, in which the tumor and entire uterus are removed. The two operations will be considered separately.
The usual operation is to secure the ovarian and uterine arteries by means of strong catgut ligatures and after the removal of the tumor, corpus uteri and supravaginal portion of the cervix, to close the uterine stump by means of a continuous suture running from side to side and then to close the wound in the broad ligaments by means of another continuous suture also running in the same direction (Fig. 1). This method is open to the following objections: 1. The severed broad ligaments retract to the sides of the pelvis where they can no longer give adequate support to the bladder, vagina and the rectum, and where they consequently
E. C. DUDLEY. END-TO-END APPROXIMATION OF THE BROAD LIGAMENTS AND OTHER POINTS OF TECHNIQUE IN ABDOMINAL HYSTERO-MYOMECTOMY.. JAMA. 1902;XXXVIII(13):805–812. doi:10.1001/jama.1902.62480130003001a