Operative surgery, for students and practitioners . Fig. 316.—Perineal Prostatectomy (Young). Membranous urethra opened justanterior to prostate and tractor introduced. Incision through the sheath ofprostate. Detaching the sheath from the right lobe with the blunt dissector. 702 URINARY SYSTEM. injur)^ The incisions, being 1 cm. deep, reach into the substance ofthe prostate beyond the level of the ducts and close to the sides of theurethral canal. The fibrous sheath is separated from the prostate with the bluntdissector. It is important to start in the correct line of this step of
Operative surgery, for students and practitioners . Fig. 316.—Perineal Prostatectomy (Young). Membranous urethra opened justanterior to prostate and tractor introduced. Incision through the sheath ofprostate. Detaching the sheath from the right lobe with the blunt dissector. 702 URINARY SYSTEM. injur)^ The incisions, being 1 cm. deep, reach into the substance ofthe prostate beyond the level of the ducts and close to the sides of theurethral canal. The fibrous sheath is separated from the prostate with the bluntdissector. It is important to start in the correct line of this step of the operation progresses the lobe is drawn more andmore out of its sheath. The urethra is then detached from the glandfirst on one side and then on the other, drawing down with the tractor. Fig. 317.—Enucleation of Middle Dobe. The finger is introduced into theempty, right pocket to force a middle lobe into the other, left, pocket throughwhich it may be enucleated. at the same time. In detaching the upper part of the prostate, thatpart which corresponds to the neck of the bladder, care must be exer-cised to separate the wall of the bladder without injuring it. Toomuch force must not be used with the tractor because, the supporthaving been removed below by detaching the prostate all around, thereis danger of tearing abruptly through the mucous membrane of thebladder. The partially enucleated mass may be seized with forcepsfor the purpose of making traction and thus facilitating its half of the prostate mass is enucleated from the correspondingportion of the sheath without injuring the ejiaculatory ducts andwithout destroying the prostatic portion of the urethra. OPERATIONS UPON THE PROSTATE. 703 If, after both lobes have been enucleated, a median portion st
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
