A case of laparo-colpo-hysterectomiae in cancer and fibroids of the uterus

If there are also possible disputes regarding the frequency of cancer and myoma of the uterus, in general, then the combination of cancer and myoma of a large size, such that does not allow extirpationis uteri per vaginam, must undoubtedly be recognized as extremely rare. The more interesting is the issue of operational assistance in cases of this last kind. Extirpatio uteri per vaginam is possible with tumors of size, according to Schroeder and Schaut, not more than a fist, but according to Leopold, less than a child's head. Colpo-laparo-hysterectomia is expedient where the combined method has to be handled due to any unforeseen accidents during the production of vaginal extirpation. As for those cases, where already before the operation it was decided to operate according to the combined method, then it would be expedient and, so to speak, antiseptic to start the operation with laparotomy, that is, to produce not colpo-laparo-hysterectomiam, but vice versa, colpo-kysterectomiam, which operation was performed by N.A. Velyaminov in the following case.