From Big Medical Encyclopedia

CLEIDOTOMY (grech, kleis, kleid [os] a bolt, a clavicle + tome a section, a section) — obstetric operation, the cut is the purpose reduction of volume of a shoulder girdle of a fruit by a section of his clavicles.

The name of operation and the description her technicians is given by the Russian obstetrician of H. N. Fenomenov in 1889 though operation was known earlier.

Indication to a cleidotomy the impossibility to remove a coat hanger of a large fruit manual receptions after the spontaneous birth of a head or after operation is craniotomies (see), in the latter case To. is auxiliary operation. To. it is made on a dead fruit at threat of a rupture of soft tissues of a parturient canal of the woman in labor. In some cases To. it is carried out on a live fruit at the same indications.

Diagrammatic representation of operation of a cleidotomy: the head of a fruit is delayed down and aside, opposite to a clavicle; the clavicle is cut by scissors in a middle part.

The head of a fruit is delayed by the assistant down and aside in order that it was more convenient to surgeon to reach a clavicle, the turned kpereda (fig). Under direct vision or under control of fingers of the left hand the clavicle is cut by the ends of scissors of Phenomena and (or other scissors) then the circle of a shoulder girdle decreases by 2,5 — 3 cm. At insufficient reduction of volume of a shoulder girdle it is necessary to execute operation from the opposite side. For this purpose the assistant delays a head of a fruit up, the surgeon gropes the clavicle turned kzad, and cuts it. The circle of a coat hanger decreases at the same time by 5 — 6 cm.

During the performance of this operation wound of soft tissues of a parturient canal therefore it is necessary to control medical actions carefully is possible. Later To. carefully examine walls of a vagina and a neck of uterus by means of mirrors for identification of possible damages.

See also Fetaldestructive operations .

Bibliography: Malinovsky M. S. Operational obstetrics, page 321, M., 1974; The Multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 6, page 168, M., 1961; I to ate with N e in and the p E. Ya. K to a question of a cleidotomy, Works of the 7th Vsesoyuz, congress akush. and ginek., page 774, L., 1927.

S. N. Kopshev.