File:Surgical and obstetrical operations (1907) (14783227492).jpg

Identifier: surgicalobstetri02will (find matches)
Title: Surgical and obstetrical operations
Year: 1907 (1900s)
Authors: Williams, W. L. (Walter Long), 1856-1945 Pfeiffer, Wilhelm, 1870-
Subjects: Veterinary surgery
Publisher: Ithaca, N. Y., The author
Contributing Library: The Library of Congress
Digitizing Sponsor: Sloan Foundation

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heter. Fig. 8, k. In order to prevent infiltra-tion of urine after the operation, special care is to be takento make the lower end of the wound slanting in such amanner that the inner margin is higher than the outer. After the catheter has been drawn back away from theischial arch, introduce the lithotomy forceps into the urethraor bladder, grasp the stone and draw it outward in its naturaldirection. The grasping of the stone by the forceps ismaterially aided by means of the left hand introduced into URETHROTOMY. LITHOTOMY. lOI the rectum. One must avoid grasping, along with the stone,the mucous membrane of the bladder. Partial filling of thebladder with a tepid aseptic solution will aid in grasping thecalculus and in avoiding the implication of the bladder walls.By careful rotary movement and pushing the forceps back-ward and forward the operator can determine before the ex-traction of the stone if the forceps can be withdrawn easilyand without much resistance through the neck of the
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Fig, 7. Urethrotomy at the ischial notch. bladder. If the stone is so large that it can not pass theneck of the bladder lithotripsy may be performed. Thisoperation requires time and patience, since as a rule it is notpossible to encompass the entire calculus with the forceps.That is, the narrowness of the neck of the bladder preventsthe sufficiently wide opening of the forceps. The stone con-sequently must be gradually broken off at its periphery andthe individual pieces of calculus removed. The characterof the surface of the stone has an evident bearing upon thepracticability of lithotripsy. When this operation is impossible, the surgical dilation I02 URETHROTOMY. LITHOTOMY. of the pelvic urethra with the Hthotome can be undertakenas a last resort. Introduce the instrument and divide theurethra upward and laterally as the instrument is withdrawn.In order to prevent injury to the rectum it should be emptiedbefore the operation is undertaken. After the removal ofthe stone, push the cat

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