File:The practice of surgery (1910) (14592650498).jpg

Identifier: practiceofsurger00mumf (find matches)
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
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:
bladder and open the tractor. While making tractionon the prostate with this instrument, separate thoroughly with scissorsand blunt dissection the prostate and bladder before and behind fromthe neighboring tissues. By this means the mobilized bladder may be 430 GENITO-lRINARY ORGANS drawn well down into tho wound. Cut off the membranous urethra infront of the tractor; depress that instrument; open the bladder from infront with the knife, and then, with the scissors, excise the lower portionof the bladder with the prostate, seminal vesicles, and j)ortionsof the vasadeferentia, cutting off the base of the bladder about half an inch in frontof the openings of the ureters. We have now brought away the malig-nant prostate with a large margin of bladder. The stump of the bladderfalls far back, leaving a large rent to repair. It is not very difficult tofill the gap, as indicated by the diagram in the text. At one point in theanterior wall of the bladder a puckered opening is manufactured for
Text Appearing After Image:
Fig. 263.—Excision of cancer of the prostate—step 2 (redrawn after Young). suture to the stump of the membranous urethra. The remaining open-ing in the bladder-wall is then easily closed with stitches. Youngrecommends sewing up the rent with alternate catgut and silkworm-gut sutures, the latter being left long. The repair of the urethra maybe made with silk or catgut stitches; then an inlying catheter is fastenedinto the bladder, passing throughout the length of the urethra. Thedepths of the wound are filled with light gauze packing, which is broughtout through the perineal opening, the levator ani muscles are drawntogether with two catgut stitches, and the skin-wound is closed so far aspossible. CANCER OF THE PRO.STATE 431 This radical operation, if successful, is followed by a relatively shortconvalescence, and the patient may be expected to regain comparative

Note About Images