Perineorrhaphy, with special reference to its benefits in slight lacerations : and a description of a new mode of operating / by Edward W. Jenks.

  • Jenks, Edward W. (Edward Watrous), 1833-1903.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Perineorrhaphy, with special reference to its benefits in slight lacerations : and a description of a new mode of operating / by Edward W. Jenks. 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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    up the septum as far as is desired, and then laterally, first on one side, and then on the other, without removing the scissors or once bringing their points out from beneath the mucous membrane, as shown in Fig;. 3. Sometimes, instead of beginning my dissection at the median line, I begin at the nick on the left labium majus, running the points of the scissors beneath the mucous membrane, and dissecting it away from the subjacent tissues back on the left lip, then up the recto-vaginal septum as far as I deem it necessary, and from thence forward on the right lip to a point opposite from which I started (marked by the nick), without allowing the scissors to come out from beneath the membrane, unless they are accident- ally turned out by cicatricial tissue. Then with blunt-pointed scissors cut away the dissected flaps. The bared surface thus exposed is much the shape of a right- angled triangle, with the base directed outward, or it has been compared in shape to a butterfly, with wings spread and tail directed upward. The advantages of this mode of denuding are, (a) the rapidity with which it can be done ; (b) the absence of hemor- rhage in the vagina, as no blood escapes except at the locality where the scissors enter beneath the mucous membrane; (c) the ability by which the operator can make complete denuda- tion, as the discoloration beneath the membrane marks the route the scissors have taken. Several of my brother gynecol- ogists have tried this method of denuding, and -are highly pleased with it. Among them is my friend Dr. Albert H. Smith, of Philadelphia, who, thinking he could better denude with a knife than scissors, had one made, which he found after several trials to be a very satisfactory instrument, by which he can denude much more rapidly, and yet on the same principle as with scissors. The knife (Fig. 4) has a dart- shaped thin blade with double cutting edges. The patient,