. Studies on hypertrophy and cancer of the prostate. Fig. 14.—Opening of urethra on sound, preparatory to introduction oftractor. which fixes the blades in position is loosened, the blades rotated 180degrees by means of the external blades, and then fixed by tighteningthe thumb-screw (Fig. 3). ^ Carelessness in this part of the operation may lead to considerabletrouble. If the membranous urethra is not carefully exposed and thor-oughly opened, difficulty may be experienced in picking up the edgesof the mucosa of the urethra on each side. If the edges of the mucosaare not carefully secured with
. Studies on hypertrophy and cancer of the prostate. Fig. 14.—Opening of urethra on sound, preparatory to introduction oftractor. which fixes the blades in position is loosened, the blades rotated 180degrees by means of the external blades, and then fixed by tighteningthe thumb-screw (Fig. 3). ^ Carelessness in this part of the operation may lead to considerabletrouble. If the membranous urethra is not carefully exposed and thor-oughly opened, difficulty may be experienced in picking up the edgesof the mucosa of the urethra on each side. If the edges of the mucosaare not carefully secured with clamps and held apart, they may be invertedby the introduction of the tractor and the operation delayed until theycan be picked up again. study of 145 Cases of Perineal Prostatectomy. 21 The instrument is now ready for whatever traction may be neces-sary to draw the prostate well down into the perineal wound, as shownin Fig. 15. Fig. 16 shows the position of the blades in the interior. 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
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectfistula, bookyear1906
