. Studies on hypertrophy and cancer of the prostate. Fig. 15.—Tractor introduced; blades separated, traction made, exposingposterior surface of prostate. Incisions in capsule on each, side of ejacu-latory ducts. of the bladder, each blade projecting laterally so as to engage theintravesical surface of the lateral lobe. 22 Hugh H. Young. Exposure of prostate and incision of capsule.—Lateral retractorsare so placed that with the posterior retractor (Fig. 17) drawing therectum hack^^ard, and the prostatic tractor drawing the gland out-ward, a splendid exposure of the entire posterior surface of t
. Studies on hypertrophy and cancer of the prostate. Fig. 15.—Tractor introduced; blades separated, traction made, exposingposterior surface of prostate. Incisions in capsule on each, side of ejacu-latory ducts. of the bladder, each blade projecting laterally so as to engage theintravesical surface of the lateral lobe. 22 Hugh H. Young. Exposure of prostate and incision of capsule.—Lateral retractorsare so placed that with the posterior retractor (Fig. 17) drawing therectum hack^^ard, and the prostatic tractor drawing the gland out-ward, a splendid exposure of the entire posterior surface of the pros-tate is obtained. These retractors should be especially made to suit the diameters of thespace, as shown in Figs. 17 and 18. An incision is then made on eachside of the median line for almost the entire length of the posteriorsurface of the prostate and about cm. deep. The two lines are. Fig. 16.—Showing position of blades in interior of bladder in case ofmedian and bilateral hypertrophy. divergent, as shown in Fig. 15, being about cm. behind and apart in front. The bridge of tissue which lies between them ^ Even after the insertion of the tractor care must be taken in thefurther separation of the prostate and rectum, which is sometimes closelyadherent along the entire posterior surface of the prostate. After theapex of the prostate has been thoroughly exposed so that the white capsuleis plainly visible, the rest of the posterior surface of the prostate is freedby gradually pushing back the rectum with the handle of a scalpel, anddividing any muscular bands or fibrous adhesions which hinder the processof separation, but being careful to work against the prostate and not to-wards the rectum. The finger is particularly dangerous and nearly all thecases of rectal tear to which my attention has been called, have been pro-duced by the finger in attempting to r
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfistula, bookyear1906
