Surgery, its principles and practice (1906) (14771088864)

Identifier: surgeryitsprinci04keen (find matches)

Title: Surgery, its principles and practice

Year: 1906 (1900s)

Authors: Keen, William W. (William Williams), b. 1837 Da Costa, J. Chalmers (John Chalmers), 1863-1933, joint ed

Subjects: Surgery General Surgery

Publisher: Philadelphia and London : W. B. Saunders

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

Text Appearing Before Image:

and speed that Irecommend it with-out reserve, and do not hesitate to urge that it supersede the older opera-tions. The method, which I think is described very aptly by the termbottle operation, brings about a complete eversion of the whole lining,without the use of stitches, and with much less cutting than the Jaboulaymethod. Technic of the Bottle Operation.—An anterior scrotal incision ismade as in the older methods. The skin should be held tense and thedissection should be nice to the exact layer which will enucleate the trans-lucent bladder-like mass from its bed. It is not an operation for a manover forty-five to attempt without glasses.

Text Appearing After Image:

Fig. 329.—E. Wyllys Andrews Bottle Operation for the Radical Cure of Hydrocele.Hydrocele and testis enucleated. Incision at anterior upper portion. 608 SURGERY OF THE SCROTUM, TESTICLE, AND CORD. Careful study of the funicular part of the sac is now to be made.Usually a little funnel continues one or two cm. up the cord. The ex-treme upper end of this marks the beginning of the cut made into the sac.This cut is vertical on the anterior border and only about 2 cm. long(Fig. 329). We enlarge it a little by stretching. Sometimes it is whollyconfined to the part over the cord. The incision in the sac is prolongedto its extreme upper end along the cord if the first cut did not do this.When the sac has been emptied, it is like a bottle or bag, with a small holeat the top. Dilating this slightly with one or two fingers, the orifice isheld open and the testis is pushed up into it with the other hand or thetwo thumbs (Fig. 330). In a moment it can be squeezed through, andthe whole sac will i

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1906

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