Operative surgery, for students and practitioners . ctum is dissected loosefrom within the external sphincter, all around, so that it can bepulled down and out of the anal orifice for a short distance,—aboutan inch. In this way the external sphincter is left uninjured. Thelower end of the rectal tube which has thus been dissected loose fromwithin the anal margin is closed with several silk sutures which are 570 RECTUM. left long to serve as tractors. Gloves which have been used for thispart of the operation are discarded. The parts about the anus areagain thoroughly cleansed and the operator p
Operative surgery, for students and practitioners . ctum is dissected loosefrom within the external sphincter, all around, so that it can bepulled down and out of the anal orifice for a short distance,—aboutan inch. In this way the external sphincter is left uninjured. Thelower end of the rectal tube which has thus been dissected loose fromwithin the anal margin is closed with several silk sutures which are 570 RECTUM. left long to serve as tractors. Gloves which have been used for thispart of the operation are discarded. The parts about the anus areagain thoroughly cleansed and the operator proceeds to resect therectum as a closed tube. An incision is made from the anterior part of the incision thatencircles the anus^ forward, through the anterior part of the externalsphincter as far as the bulb of the urethra and another incision back-ward through the posterior end of the external sphincter, in themiddle line, as far as the tip of the coccyx, and then continued fartherbackward upon the coccyx to the base of this bone. The coccyx is. Fig. 252.—Amputation of the Rectum (Quenu). The coccyx has been enu-cleated and the rectum detached and pulled over toward the left. The rightlevator ani has been partly cut through. The bulb of the urethra is exposed inthe anterior part of the incision. B., bulb of the urethra; , the levatoresani muscles; S., lower edge of sacrum; the coccyx has been enucleated. •enucleated after detaching the soft parts with the periosteumelevator. The external sphincter is thus divided into its two halvesand left, one-half in each edge of the skin incision. The space behindthe rectum is entered and the rectum and the loose connective tissue,lymph-nodes, etc., that lie behind it all detached in one mass fromthe front of the sacrum; the levatore ani of either side is hooked downwith the finger and divided with the scissors. The rectum is sepa-rated, anteriorly, from the deep urethra, prostate gland, seminalvesicles, base of bladder in the ma
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
