Whether performed with the scissors or knife the patient is typically placed on her left side and Sims’ speculum employed.  The cervix being slit bilaterally, one lip is seized and cut off as near the vaginal junction as is deemed advisable, and then the other removed in a similar manner.  Formerly the operation was considered complete at this point until Sims introduced the practice of drawing the surrounding mucosa over the stump and securing it with silver sutures. The result was an improvement over granulation of the wound alone.  Nonetheless, the operation was frequently a bloody one.