One year's statistics of lithotomy operations performed in the Hyderabad Civil Hospital, Sind, India / by B.C. Keelan.

  • Keelan, B.C.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: One year's statistics of lithotomy operations performed in the Hyderabad Civil Hospital, Sind, India / by B.C. Keelan. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the pressure of the stone are incised cautiously in as many places as the circumstances will demand. It does not make much difference whether the obstructions be above, below, or to the right or left side; the tuber ischii, however, must be avoided, as the pudic artery runs under cover of it. The other arteries are so small that they hardly deserve much attention, as nearly all must be severed in removing a large stone through the perineum. Then, on again taking the forceps from the hands of the assistant, the narrow side of the stone should be seized, just sufficiently far from the edge to prevent the blades from slipping. To render this easy, the probang should be passed through the wound and the stone gently tapped or pushed with it a few times while the forceps are slight- ly relaxed. It is not a good practice to enclose the stone completely within the blades. The calculus is again gently pulled or rocked as before. When the stone is small, there is of course no difficulty in its re- moval. But when it reaches from 2h to 5 ozs., then I find its successful removal can only be accomplished by attending to the above remarks. When a stone is large and round it cannot usually be removed by an ordinary stone forceps owing to its liability to slip away from the grasp of the blades. To obviate this, I use a forceps as shown in the accompanying drawing. It will be observed that the blades are bent near their extremities to meet at an acute angle. A stone seldom slips from a forceps made in this way.