Operative surgery . a whalebone guide into the bladder in tliemanner before described (page 420); over this pass thegrooved or tunneled catheter staff down to and throughthe stricture (Fig. 130T), if it can be done readily; ifnot, allow its beak to rest against the obstruction, theinstrument being carefully supported by an assistant,who at the same time raises and holds the patient is now placed in a lithotomy position, andthe limbs supported by an assistant upon either side. The surgeon, sittingupon a low stool facing the perinfeum of the patient, introduces the leftindex finger i
Operative surgery . a whalebone guide into the bladder in tliemanner before described (page 420); over this pass thegrooved or tunneled catheter staff down to and throughthe stricture (Fig. 130T), if it can be done readily; ifnot, allow its beak to rest against the obstruction, theinstrument being carefully supported by an assistant,who at the same time raises and holds the patient is now placed in a lithotomy position, andthe limbs supported by an assistant upon either side. The surgeon, sittingupon a low stool facing the perinfeum of the patient, introduces the leftindex finger into the rectum to ascertain the condition of the membranousand prostatic portions of the canal. A free incision, from an inch to an inchand a half long, is then made in the median line of the perinffium, extend-inor from the base of the scrotum to witliin half an inch of the anus, throughthe integument and fascia. The grooved instrument is carefully located by Fig. 1495.—Symesgrooved staff. 1250 OPEEATIVE the finger, and the urethra bronglit into view by repeated cuts in the sameline. The nail of the index finger assures the surgeon of the location of the groove, and tlie urethra is divided longitudinallyupon it. Two silk trac-tion loops are now passed,one through each bor-der of the divided ure-thra, and are given incharge of assistants, whoare instructed to care-fully draw the lips ofthe wound apart (). This importantstep exposes the mucouswall of the urethra com-pletely, enabling theoperator to follow itscourse by carefully ob-serving the continuityof its structures. Thestaff is now withdrawnsufficiently to expose theblack whalebone guide,then the beaked bistoury(Fig. 1498) is intro-duced in its course, andthe stricture, together with about half an inch of the canal immediatelybehind it, is divided in the median line. The entrance of a grooved director or a small gum catheter through theopening into the bladder, followed by the flow of urine, assures the
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
