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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ns perforate the glans from before backwards or fromabove downwards and backwards (Ochsner) and pull the mobilized end ofthe urethra through the tunnel, suturing it there. When the defect belongsto the penile or scroto-perineal type, other operations are required. DUPLAY S OPERATION 729 Dnplay^s Operation.—First sitting: Straightening of the penis. Second sitting: Correction of the deformity in the glans, as in Thierschsoperation for epispadias. Third sitting: Establish perineal drainage, by the boutonniere operation.C. H. Mayo advises the introduction of a Pezzers self-retaining female catheterthrough the perineal wound. Correct the urethral deformity as follows: Makea longitudinal incision (a, b, Fig. 891) parallel to and about ^4 inch distantfrom the edge of the urethral groove. At each end of this incision make a trans-verse incision beginning at the edge of the urethral groove and ending at a pointwell external to the longitudinal cut. These cuts outline two flaps, one of which
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1 l^Jt i mtf- J Fig. 889. Fig. 890. Figs. 889 and 890.—(Beck.) (x. Fig. 891) has its base at the urethral groove; the other, p, has its base towardsthe side of the penis. Reflect these flaps. On the opposite side of the urethralgroove duplicate the above incisions and form the flaps y and q. Pass a rodthrough the lately formed urethra of the glans and permit it to lie in the urethralgroove. Reflect the flaps x, y, on to the rod (Fig. 892) so that their epidermalsurfaces next to the rod and their raw surfaces are exposed. These two flapsshould not be so wide that their edges meet over the rod. Approximate the flapsp and Q by means of the suture s s^ (Fig. 892). The skin is so loosely attachedto the penis that it is easy to slide the flaps p and q inwards so that their rawsurfaces are partly in contact with those of x and y and partly with one another.The sutures, of silkworm-gut or silver wire, should be fastened to perforated leadplates which extend the whole length of the wound on

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