Anatomical dissection
The corpses were placed on the examining table in the supine position
with the lower extremities separated laterally and bent in the knees-hip
joints and the upper limbs along the body side. To stabilize the body in
this position, a medical bandage was placed between the ankle and wrist
to hold them together, and the knees were kept laterally by fixing them
to IV poles. Dissection planes were in various directions a) vertical
plane from front to back that splits the vaginal outlet wall into
visible layers; b) coronal-vertical planes, which allow visualizing the
front and back of the segments of the vaginal outlet wall and its
variations among the subjects The author executed all the anatomical
macro- and micro-dissection.
All macro- and micro-dissections were performed with a 3.5-4.0x
magnification loupe. The labium minus was despised laterally from the
midline, and traction 2-0 size sutures were used to secure the labia to
the vulvar skin—this maneuver allowed access to the vaginal outlet.
The vaginal outlet was marked with a dermo-marker at 12, 6, 3, and 9
o’clock for the future orientation of taking biopsies for histological
examinations.
In the sulcus between the labia minora minora, the fossa navicularis,
and under the inferior membraneous urethral sphincter, the incision was
made to expose the outer surface of the vaginal outlet wall. To
visualize the inner surface of the vaginal outlet wall, the incision was
made at the junction of the vaginal wall and the vaginal outlet inner
surface. The Bartholin’s duct orifice and membranous urethral sphincter
were outside the incisions.
The subsequent step was to make the vertical incision on the
posterior-midline hymeneal membrane with the number 15-blade of the
surgical scalpel to dissect the soft tissue from the hymeneal ring to
demonstrate a well-defined white color structure, resembling a cartilage
appearance that fuses inferiorly with the hymeneal plate and superiorly
with the hymeneal membrane. The dissection continued until the entire
hymeneal plate was visualized. Consequently, the three anatomical layers
of the vaginal outlet wall are identified. The vertical position vaginal
outlet wall fuses with the vaginal wall that is in a horizontal
position.