File:Operative surgery, for students and practitioners (1913) (14592905938).jpg

Identifier: operativesurgery1913mcgr (find matches)
Title: Operative surgery, for students and practitioners
Year: 1913 (1910s)
Authors: McGrath, John J. (John Joseph), b. 1866
Subjects: Surgery, Operative
Publisher: Philadelphia, Davis
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
with the scissors. The rectum is sepa-rated, anteriorly, from the deep urethra, prostate gland, seminalvesicles, base of bladder in the male, and from the posterior wall ofthe vagina in the female. In the male a catheter in the urethra willindicate the position of the urethra and protect it from injury. OPERATIONS UPON THE ANUS AND RECTUM. 571 After the levatores ani have been cut and the rectum separatedanteriorly it may be drawn down sufficiently to show the peritonealfold which is reflected upon its front surface. This fold is incisedclose to the wall of the rectum, first around one side and thenaround the other. The peritoneal cavity which has been thus openedis packed temporarily with gauze. The rectum may be dra\vn downout of the incision for a distance of four or five inches. The effortto pull the rectum down still farther out of the incision is resistedby the folds of peritoneum that pass from the upper part of therectum back to the sacrum, and which correspond to the folds of
Text Appearing After Image:
Fig. 253.—Amputation of the Rectum (Queuu). The levatores ani have beendivided and the rectum drawn down still farther out of the incision. The bulbof the urethra, the posterior surface of the prostate and the recto-vesical foldof peritoneum are exposed. B., bulb of the urethra; L.A., levator ani muscle;P., recto-vesical fold of peritoneum; PR., prostate gland. peritoneum that form the mesosigmoid (pelvic colon). The superiorhemorrhoidal artery descends between these folds to reach the rectum.A clamp is applied to the peritoneal fold, close up to the sacrum,and the fold divided in front of the clamp, between the clamp andthe rectum. The clamp has the superior hemorrhoidal vessels in itsgrasp. The rectum may now be pulled down freely out of theincision. The rectum is drawn out until a portion of the sigmoidflexure, well above the disease, can be brought down into the analmargin without tension. Occasionally the mesosigmoid is quite shortand resists the effort to- pull down the end of

Note About Images