The treatment of laceration of the cervix is operative. A definite mechanical injury has been inflicted, and the parts must be repaired by operation.
The operation for the repair of a lacerated cervix is called trachelorrhaphy. The operation consists in denuding or excising the tissues on the torn surfaces and bringing the freshened surfaces together with sutures.
The form of the operation for a bilateral laceration is shown in [Fig. 104]. The operation should preferably be performed immediately after a menstrual period.
The instruments necessary for the operation of trachelorrhaphy are two double tenacula, two single tenacula, tissue-forceps, needle-holder, shot-compressor, Sims’ speculum, needles, ([Fig. 102]), knife, and scissors, sharp-pointed and curved on the flat ([Fig. 103]). The needles should be spear-pointed and should be strong and sharp, as the cervical tissues through which they are passed are often very dense. The straight or the curved needle may be used.
Fig. 102.—Cervix-needles.
Silkworm gut, shotted, is an exceedingly good suture-material.
The woman should be placed either in the Sims or the dorso-sacral position. The vulva, vagina, and cervix should be thoroughly cleansed and rendered as aseptic as possible. The cervix should be exposed through the Sims speculum. The anterior and, if desirable, the posterior lip of the cervix should be seized with a double tenaculum and held by an assistant; or the lip may be transfixed by a silk ligature, with which the cervix may be held.
Fig. 103.—Curved scissors for performing trachelorrhaphy.