. Manual of operative surgery. gh the a corresponding cut in the urethra (Figs. 898 and 899). Suture thesplit urethra to the skin. This splittingand suturing prevents contraction. NicoU, most sensibly, modifies theoperation as follows: Step (a): Makean incision over each inguinal these incisions in the middle lineat the root of the penis and from theirpoint of union make an incision alongthe mid-dorsal line of the penis to theplace chosen for amputation. Step (6):Beginning at each groin dissect free, fromthe outside inwards, the lymphatics of thegroins and then, from abo
. Manual of operative surgery. gh the a corresponding cut in the urethra (Figs. 898 and 899). Suture thesplit urethra to the skin. This splittingand suturing prevents contraction. NicoU, most sensibly, modifies theoperation as follows: Step (a): Makean incision over each inguinal these incisions in the middle lineat the root of the penis and from theirpoint of union make an incision alongthe mid-dorsal line of the penis to theplace chosen for amputation. Step (6):Beginning at each groin dissect free, fromthe outside inwards, the lymphatics of thegroins and then, from above downwards,those of the dorsum of the penis. Re-move all these lymphatics in one piece. After this proceed to amputate. II. Complete Amputation. (Goulds method.)—Place in lithotomy position. Step I.—Split the scrotum completely along raphe, and thoroughly exposethe corpus spongiosum. Step 2.—Pass a sound through the urethra to the triangular the corpus spongiosum from the corpora cavernosa. Remove the. Fig. 898 and 899. Fig. of penis. 734 AMPUTATION OF PENIS sound. Divide the corpus spongiosum and isolate the urethra as far as thetriangular ligament. Step 3.—Continue the scrotal incision through the skin around the rootof the penis. Divide the suspensory ligament. Separate the crura from thepubic bones. The only vessels requiring ligation are those of the crura. Thiscompletes the amputation. Step 4.—Make a short split in the urethral stump. Suture the edges ofthe split urethra to the posterior portion of the scrotal wound. Step 5.—Suture the skin wound after providing for drainage. Remarks.—Very good results have been obtained by the above operationswith or without removal of the inguinal lymph glands. Cancer of the penisis usually of comparatively slow growth. Recurrence usually is in the lymphglands. Butlin advises removal of the inguinal glands as a secondary opera-tion. If the urethra is split and united to the skin
Size: 1682px × 1485px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
