TRACHELORRHAPHY

From Big Medical Encyclopedia

TRAHELORAFYYa (Greek trachelos a neck, a neck + rhaphe a seam) — suture on a neck of uterus. It is made at ruptures of a neck of uterus at the time of delivery (in an early puerperal period), at old side ruptures of a neck of uterus, after wedge-shaped excision of a neck of uterus in a front or back lip for the purpose of an expanded biopsy or elimination patol. center. Contraindications are erozirovan-ny ectropion (see the Uterus, tumors), pregnancy and acute inflammatory diseases of genitalias.

It is offered in 1869 by Emmett (Th. A. Emmet) for sewing up of ruptures of a neck of uterus.

Vaginal speculums bare a neck of uterus, both lips take bullet nippers and reduce a neck to an entrance to a vagina; under a mucous membrane of a vulval part of a neck of uterus on both sides enter into corners of gaps on

10 ml 0,25% of solution of novocaine. Bullet nippers open a uterine pharynx (a uterine opening, T.) and the cervical channel then a scalpel cut out a rag no more than 3 mm thick, at old gaps — all cicatricial fabric (at sewing up of old gaps success of operation depends on careful release of cicatricial fabric). The internal border of a section shall pass on edge of a mucous membrane of the channel of a neck of uterus, outside — on border of a mucous membrane of a vulval part of a neck. After removal of a rag from front and back lips of a neck of uterus put knotty stitches from a catgut No. 3, without piercing a mucous membrane of the channel of a neck of uterus. Considering rigidity of tissues of neck of uterus, it is necessary to sew with «vykoly», taking the mucous membrane covering a neck of uterus, and a muscular layer in a seam. Seams are tied from the outer side of a neck of uterus. At a bilateral gap it is more convenient to make refreshing of a mucous membrane from two parties, and then to put stitches. At an arrangement of a gap on a back or front wall of a neck of uterus of the technician of mending the same. However at a high rupture of a front wall previously on a front vault of the vagina make cross section, otseparovy-vat a bladder and only after that start refreshing of area of a gap and suture. At ruptures of a neck of uterus of the III degree (see Childbirth, patrimonial traumatism) for the purpose of prevention of bleeding impose 1 — 2 seam from capron on an upper corner of a wound.

In the postoperative period in connection with a failure of healing of fabrics on a neck of uterus with 3 — the 4th day apply UVCh on area of a stomach. The patient allow to rise on 2 — the 3rd day after operation, write out on 8 — the 10th day. Sex life is allowed later 4 — 5 weeks after operation.

Bibliography: Braude I. L. Operational gynecology, M., 1952; Eltsov-Strelkov V. I. and Yermolova N. P. Surgical treatment of ruptures of a neck of uterus with ectropion of a mucous membrane of the cervical channel, Akush. and ginek., No. 9, page 59, 1976; The M is scarlet also N about in with to and y M. S. Operational obstetrics, M., 1955; Persiani-

N about in L. S. Operational gynecology, M., 1976; The Raman N. P. Gynecologic vulval operations, M., 1978; Emmet T. A. Surgery of the cervix in connection with the treatment of certain uterine diseases, Amer. J. Obstet., at. 1, p. 339, 1869. H. P. Romanovskaya.

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