Operative surgery . to the centersof the vertical incisions. Tiie incision, completing the inner border of eachflap, is carried from the lower end of the vertical incision already madealong the side of the urethral groove for half its length. After proper sep-aration of the flaps the central or umbilical flap is turned downward andstitched at either side to the cut edges of the root of the penis. The lateralflaps are carried inward over the umbilical flap, thus apposing the raw sur-faces of the respective flaps to each other. The flaps, and the borders of thegaps resulting from their displacem
Operative surgery . to the centersof the vertical incisions. Tiie incision, completing the inner border of eachflap, is carried from the lower end of the vertical incision already madealong the side of the urethral groove for half its length. After proper sep-aration of the flaps the central or umbilical flap is turned downward andstitched at either side to the cut edges of the root of the penis. The lateralflaps are carried inward over the umbilical flap, thus apposing the raw sur-faces of the respective flaps to each other. The flaps, and the borders of thegaps resulting from their displacements, are united as indicated in the illus-tration (Fig. 1337), leaving the unclosed spaces to heal by granuhition. Theroot of the penis should be closely embraced by the lateral flaps to preventsubsequent weakness and protrusion at this point. The integrity of theexternal pudic vessels will add much to the vitality of the lateral flaps. 1^. Fig. 1336.—Woods operation for extrover- Fig. 1337.—Woods operation for extrover-sion of bladder, a. Central flap, h, c. sion of bladder, a. Upper flap raw sur-Lateral flaps. face, b, c. Lateral flaps, d. Prostate body. e. Penis. Aseptic precautions and careful handling of the flaps are important de-siderata. The Comments.—The flaps should be made of as nearly nnifonn thick-ness as possible and not too thin, as then they will slough. At the uppermargin of the bladder the tissues are so thin that the peritonaeum may becut unless care be taken. Harelip sutures need not necessarily be employed. Modifications of WoocVs Operation.—Robson modified Woods operationin a case of his own in the following manner: A large square flap was takenfrom the abdominal wall above the umbilicus and turned downward sothat the cutaneous surface came in contact with the exj)osed vesical mucousmembrane (Fig. 1338). Pyriform flaps, one on each side, were taken fromthe lateral aspects of the abdomen and
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