When the external genitals cannot be removed, the vagina and rectum,
after they have been freed from the surrounding tissues, are put on
the stretch toward the head of the body and cut through as close
to the pubic outlet as possible. When this is carefully done it is
possible to secure the inner labia and the urethra intact. The rectum
is cut as close to the anus as possible. The organs are then stripped
up to the brim of the pelvis, then held up perpendicularly while
the remaining connections are severed. The organs thus removed are
examined on the board in the same manner as given above. When the
organs cannot be removed from the body, the bladder and urethra are
examined by an anterior median incision after they have been freed
from the symphysis. The uterus and vagina are then cut with the knife
in the anterior median line, either through the bladder or after
the latter has been dissected away. The ovaries, tubes and broad
ligaments are then examined as directed above. The uterus and vagina
may also be dissected from the rectum and opened by a posterior
median incision. This method is used in medicolegal examinations.
To facilitate the removal of the genital organs in either sex a
symphysiotomy may be performed and the pubic arch pulled apart, or
a portion of the pubis may be cut out with the saw.
When permission to open the body by means of the usual
main-incision cannot be obtained, it is possible to remove the
thoracic and abdominal organs through the vagina or rectum. The
cadaver is placed on its back, with buttocks near the end of the
table, the thighs separated as widely as possible and flexed upon
the body. In the male the scrotum is drawn up out of the way. A
circular perineal incision is then made, beginning anteriorly at
the perineoscrotal junction and extending around the anus. The arm
may be introduced through this opening after the removal of the
rectum and the abdominal and thoracic organs pulled downward and
removed. In the female the uterus and vagina are removed through
the vaginal opening; the arm is then introduced and the abdominal
and thoracic organs removed.
II. POINTS TO BE NOTED IN THE EXAMINATION OF THE PELVIS.
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