Identifier: textbookofoperat1903koch (find matches)
Title: Text-book of operative surgery
Year: 1903 (1900s)
Authors: Kocher, Theodor, 1841-1917 Stiles, Harold J
Subjects: Surgery, Operative Surgery
Publisher: London : Adam and Charles Black
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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PERINEUM 275
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276 OPERATIVE SURGERY they should, if possible, be avoided, and the transverse curved incision shouldtherefore be looked upon as the normal incision for obtaining free access. Acurvedincision is carried from one ischial tuberosity to the other, its convexity reachingforwards to the lower border of the pubic symphysis (Fig. 127). After division ofthe skin and thin superficial fascia, the incision comes down laterally upon the fattytissue which is continued upwards into the ischio-rectal fossae between the pelvis andthe rectum. This fatty tissue is now dissected through as far as the under surfaceof the levator ani, the fibres of which extend from before backwards and from withoutinwards towards the rectum. By this means the inferior haemorrhoidal vessels andnerve situated posteriorly, and the transverse perineal vessels and nerve, the arteryand nerve to the bulb, and the transverse superficial perineal muscles, all situatedanteriorly, are pushed forwards and drawn out of the way. The b

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