Identifier: manualofoperativ1921binn (find matches)
Title: Manual of operative surgery
Year: 1921 (1920s)
Authors: Binnie, John Fairbairn, 1863-1936
Subjects: Surgery, Operative
Publisher: Philadelphia : Blakiston
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ectionable, hence Rosenbergers ingenious and simple opera-tion is to be condemned and will not be described. The Van Hook-Mayo operation for hypospadias is entirely suitable in casesof epispadias. CANTWELL S OPERATION 725 Cantwells Operation.—This most ingenious and logical operation (AnnalsSurg., Dec, 1895) seems to have been unaccountably overlooked. The authoris indebted to Wetherill for drawing his attention to it. Step I.—Open the bladder through the perineum and introduce a Watsondrainage-tube. Step 2.—Recognize the line of junction between the mucosa of the gutter-like uretrha and the skin of the penis. On each side of the urethral groovemake a longitudinal incision along the lines of muco-cutaneous junction,from the symphysis to the extremity of the glans. (Fig. 882, a.) Unite theincisions above the opening into the bladder. The incisions penetrate to, butmust not injure the corpora cavernosa. Separate the urethra, as a flap, fromits bed and hold it aside. (Fig. 882, h.)
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(a) (d) Fig. 882.—Cantwells operation. Step 3.—With sharp and blunt dissection separate the one corpus caverno-sum from the other until the skin on the lower surface of the penis is reached.(Fig. 882, c.) Step 4.—Place the mobilized urethra in the bottom of the long penile woundand fix it there by a couple of sutures. Step 5.—^Lay a sound or a glass rod along the urethra (which is a meregroove) and suture the urethra over the rod so as to form a tube. Removethe rod. Step 6.—Bring the corpora cavernosa together over the urethra and closethe wound. (Fig. 882, d.) The urethra now occupies its normal site. Harold Stiles Operation.—(Epispadias in the female Trans. Am.Surg., Assoc, 1911.) 1. Trendelenburgs Position.—Subumbilical right rectus incision. 2. Divide the peritoneum covering the ureter where it crosses the termina-tion of the internal iliac artery to go downwards and forwards towards thebase of the broad ligament, a little below the infundibulopelvic ligament andthe

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