The surgical anatomy of the perinaeum Author:Thomas Morton Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: .1 This engraving represents the section of the left lobe of the prostate gland, which is made in the lateral operation of lithotomy. The parts have been diss... more »ected after having been separated from all their connexions. a. marks the incision, which, commencing in the membranous portion of the urethra, extends very near to the base or posterior edge of the left lobe of the prostate gland. 6. The left lobe of the prostate gland. .6. The right lobe of the gland. A slight projection in the posterior border of the gland marks the position and form of the third or middle lobe. c, The bulb of tlie urethra. Close behind are observed the two small granular masses named Cowper's glands. d. d. The crura of the penis. e. e. The vesicular semi- nales. f. f. The vasa deferentia. g. The ureter of the left side. There are three principal methods of cutting into the bladder for the purpose of extracting a calculus from its interior :' viz. first, by an incision through the perinaeum ;. secondly, through the rectum; and thirdly, above the pubis. These various methods have been practised more or less extensively at different periods; though at the present day the two last-named are very seldom employed, and then only in consequence of som% particular circumstances. It is thus that the operation of ltthotomy above the pubis is usually reserved for those cases in which the calculus is of too large a size to admit of being safely extractedthrough the perinaeum, or in which the prostate gland is much enlarged. The employment of the recto-vesical method has been, in a great measure, confined to those surgeons who first introduced it. The lateral operation of lithotomy as performed with the knife. —The staff should be introduced into the bladder, and the stone felt previously to fixing the patient...« less