A new lithotomy operation / by Hugh Owen Thomas.

  • Thomas, Hugh Owen, 1834-1891
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: A new lithotomy operation / by Hugh Owen Thomas. Source: Wellcome Collection.

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    By Hugh Owen Thomas (Liverpool). Many modifications of the old lateral operation of lithotomy have been introduced into surgery during the last century, mostly devised to minimize its dangers, yet in some degree to lessen the amount of manual dexterity— required for the successful performance of the operation. I have operated up to this date upon thirty cases ; not an exten- sive experience, true, but this number affords a fair opportu- nity of becoming familiar with the operation. The first case in which I operated, the ordinary curved staff with lateral groove was used; the incision and penetration were performed with an ordinary scalpel; the case was a success ; and on cogitation it appeared to me to be an unsatisfactory manner of incising the bladder for the removal of stone, too much being left to the surgeon's skill. On reviewing the various methods, Civiale's medio-bilateral operation presented an important advantage, as it afforded a larger incision on entering the bladder, and consequently caused less injury in withdrawing the stone. This operation I performed twice, using his curved median staff and double-bladed bistoury. These two cases were also successful, but there was secondary haemorrhage in both instances; this mode of operation appears to be safer and simpler on paper than in practice. My next change occurred when Mr. Hutchinson published his medio-bilateral operation with rectangular staff and median groove, flat bilateral cutting gorget, with probe point. One operation I performed by Hutchinson's method; this was a success; but as a whole the mode of operation did not satisfy me; nevertheless, Mr. Hutchinson's hollow staff, with median groove, excited my admiration, and I decided, that if I operated again, to employ this excellent instrument in combination with Civiale's double- bladed bistoury. This decision I was able to test, and was so pleased that I thought I had now a plan of operation which would come up to my ideal. Before long I discovered in Braithwaite's Retrospect a description of Dr. Corbett's double rectangular staff with lateral grooves. This, I at once saw, could be adapted to the median operation, and I planned a method and means of operation which may be said to be copied from—The old operation, a scalpel; from