LESSON 2: Procedures in Gynecological and Obstetrical Surgery

Section Ii: vaginal surgery

2-19

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2-19. EXCISION OF FIBROMA OF THE VAGINA

a. General. This procedure involves the removal of the lesion through a transverse or longitudinal incision of the wall of the vagina. Small cysts or small benign tumors that distort the vagina or those that are ulcerated and infected are the kind of lesions removed in this surgery.

b. Operative Procedure.

(1) The vaginal vault is retracted, using lateral and Sims retractors. Traction sutures of chromic gut number 0 or silk number 2-0 are placed on each side of the tumor. The posterior lip of the cervix is grasped with a Jacobs vulsellum forceps and drawn anteriorly to expose the operative site.

 

(2) The vaginal wall is incised, and the edges are grasped with traction sutures on curved, taper point needles or with Allis forceps.

 

(3) The cyst and its capsule are excised, using a knife and curved scissors; bleeding vessels are clamped and ligated, using Halsted forceps and fine sutures.

 

(4) The vaginal incision is closed with interrupted sutures of chromic gut number 2-0, and dressings are applied.

 

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