The removal of the uterus has been rendered so safe that even in advanced age it has been employed with success, as the subjoined table shows:—
Table of Cases in which Hysterectomy was performed on Women of Seventy Years and upwards.
| Reporter. | Age. | Nature of Operation. | Result. | Reference. |
|---|---|---|---|---|
| Bland-Sutton | 73 | Subtotal for Fibroid 28 lb. | R. | Trans. Obstet. Soc., 1900, xli. 300. |
| Stewart McKay | 70 | Subtotal for Fibroid 19 lb. | R. | Australian Med. Gaz., 1907, 14. |
| Bland-Sutton | 83 | Vaginal Hyst. for Villous disease. Fig. 15. | R. | Trans. Obstet. Soc., 1906, xlix. 46. |
| Malcolm | 74 | Total for Fibroids. | R. | Brit. Med. Journal, 1907, ii. 1571. |
ABDOMINAL MYOMECTOMY
Under this general term it is usual to include operations for the removal, through an abdominal incision, not only of pedunculated subserous fibroids, but also sessile and interstitial (intramural) fibroids of the uterus.
The earliest operations of this kind were performed by Spencer Wells (1863); but little attention was given to this matter until the advantages of abdominal myomectomy were strongly advocated by A. Martin (1880) and Schroeder (1893). The operation has been practised by many surgeons and gynæcologists imbued with conservative ideals in regard to the uterus. In its early days the operation was attended with a very high mortality, but the great improvements in hysterectomy have limited very materially the scope of abdominal myomectomy.
ABDOMINAL MYOMECTOMY AND ENUCLEATION FOR FIBROIDS
Abdominal myomectomy. This signifies the removal of one or more pedunculated subserous fibroids through an incision in the abdominal wall, preserving the uterus, Fallopian tubes, and the ovaries.
Abdominal enucleation. In this operation a sessile fibroid is shelled out of its capsule: the uterus, ovaries, and tubes are preserved.