File:Operative gynecology - (1906) (14596860560).jpg

Identifier: operativegynecol001kell (find matches)
Title: Operative gynecology :
Year: 1906 (1900s)
Authors: Kelly, Howard A. (Howard Atwood), 1858-1943
Subjects: Gynecology Gynecology Gynecologic Surgical Procedures
Publisher: New York and London : D. Appleton and company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ingand reading off the size.By deducting the caliberfrom the diameter thethickness of the wall ismeasured. 356 AFFECTIONS OF THE URETHRA AND BLADDER. outer end of the speculum 15 mm. long, inclined at an angle of sixty degreesto the cylinder. The handle, 8 cm. (3 inches) long and 12 mm. broad and5. mm. thick, is attached to the funnel and is large enough to afford a con-venient grasp which does not tire the hand during a prolonged examination. My first specula were furnished with handles so small that they had to beheld between the thumb and the index finger. The handle used after thisis seen in Fig. 216. I now prefer handles about twice this size, or even aslarge as that shown in Fig. 215. The vesical end of the speculum must be rounded in toward its lumen,and under no circumstances must a ragged or a knife edge be left to cut themucosa. Specula are made in various numbers ranging from 5 to 20, each numberrepresenting the diameter of the cylinder in mm.—5, 6, 7, etc., up to 20; the
Text Appearing After Image:
Fig. 215.—The Stout Handle Attached to the No. 10 VesicalSpeculum. A Handle of this Size is Much More Convenientthan a Shorter One. specialist will also find it convenient to have on hand the following half sizes:6^, 7-J, 8-J, 9-J, 10^, 1H. The sizes below No. 12 are used for examination,and those above to secure a wide lumen in operations upon the bladder. . Each instrument has its obturator, only used for the purpose of round-ing out the end of the speculum during introduction; the obturator consistsof a conical end piece connected by a slender shank to a stout handle whichfits into the funnel of the speculum. The shank of the obturator is made stout enough not to bend in withdrawal,and the handle is large, so as to give a good hold for the thumb and indexfinger. To facilitate the introduction of the cystoscope there must be no shoulderto injure the urethra between the end of the speculum and its obturator. CYSTOSCOPY. 357 The dilator is a conical instrument 1blunt point 3 mm. in

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