. Surgery, its principles and practice . !^ Fig. 269.—Extirpation of the Penis. TheTesticles Separated. Fig. 270.—Extirpation of the Penis, Show-ing Dissection of Urethra. ceeds to extirpate the organ. The patient is placed in the perineal lithot-omy position. A steel bougie is inserted into the urethra. An incision OPERATIONS UPON THE PENIS. 493 is made along the raphe of the scrotum from the root of the penis down tothe perineum. By the aid of scissors and blunt dissection the scrotum isdivided in the middle line, separating the tunica vaginahs, each con-. FiG. 271.—Extirpation of the Penis.
. Surgery, its principles and practice . !^ Fig. 269.—Extirpation of the Penis. TheTesticles Separated. Fig. 270.—Extirpation of the Penis, Show-ing Dissection of Urethra. ceeds to extirpate the organ. The patient is placed in the perineal lithot-omy position. A steel bougie is inserted into the urethra. An incision OPERATIONS UPON THE PENIS. 493 is made along the raphe of the scrotum from the root of the penis down tothe perineum. By the aid of scissors and blunt dissection the scrotum isdivided in the middle line, separating the tunica vaginahs, each con-. FiG. 271.—Extirpation of the Penis. Di-vision OF Suspensory Ligament andExposure of the Crural AttachmentsTO the Pubic Bone. Fig. 272.—Extirpation of the Penis. Com-plete Extirpation with UrethraPulled Down and Divided on the RoofTO Make a Fan-shaped Flap. taining a testicle, which is held aside until the corpus spongiosum isfreely exposed at the bottom of the wound. The corpus spongiosum isnext dissected free from its attachment to the cavernous bodies. Theurethra is freed, if necessary, asfar back as the anterior leafletof the triangular ligament. Thebougie is removed, and theurethra cut across and placedto one side until the succeedingsteps of the operation are com-pleted. A circular incision thatcompletely surrounds the rootof the penis and divides theskin down to the fibrous sheathof the penis is now made. The skin-flap is pushed backtoward the pubes, the suspen-sory ligament divided, and thecavernous bodies detached untilonly those of the crura remain,which are severed in tu
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