OPERATIONS 



922 



OPERATIONS 



tion of the scrotum by means of a special apparatus. 

 Richter's : I. For iridotomy ; the same as A/f^«- 

 bach's operation. 2. For stricture of the lacrymal 

 duct ; incision of the sac and dilatation of the duct by 

 means of catgut strings. Ricord's : I. For circum- 

 cision ; the prepuce is grasped with fenestrated forceps 

 corresponding with the direction of the corona, and 

 the forceps is slid in advance of the glans ;. the pre- 

 puce is cut oft" in front of the forceps, which are then 

 removed and the mucous membrane is trimmed off, 

 leaving a short stump; stitches are next applied. 2. 

 For varicocele ; the introduction of two double ligatures 

 through a single opening in the scrotum, one pass- 

 ing above and the other below the veins ; the ends 

 of the ligatures are attached to a yoke provided 

 with a screw, which is tightened from day to day. 

 Riesel's, for the radical cure of inguinal hernia ; the 

 external ring is exposed by an incision ; the anterior 

 wall of the canal is split up to the internal ring; 

 the neck of the sac is tied as high as possible ; part 

 of the anterior wall of the canal is cut away, and 

 deep transverse sutures are then introduced. Rig- 

 aud's, for urethroplasty ; a quadrilateral flap with its 

 base above is turned over the fistula, and lateral flaps 

 are brought over the first and secured in position by 

 sutures. Riggs', for the radical cure of inguinal 

 hernia; a variety of seton-operation, the peculiarities 

 of which consist in the use of a large-sized meche and 

 an ingenious stop-needle. Rima's, for castration ; a 

 U-shaped flap is cut by transfixion from the posterior 

 wall of the scrotum. Rizzoli's: I. For ankylosis of 'the 

 lower jaw ; a linear osteotomy through the mucous 

 membrane, thus avoiding an external scar. 2. For im- 

 perforate anus (the rectum terminating in the vagina) ; 

 an incision is made in the perineum, antero-posteriorly 

 — if the anus is absent — followed by dissecting the 

 rectum from the vagina, and after pulling the former 

 down, it is stitched to the skin-incision. Roberts' 

 [J. B.), for deflected nasal septum; a linear in- 

 cision is made with a bistoury along a prominent 

 line of the deflection, so as to enable it to be pressed 

 into its proper position, after which a long steel 

 pin is thrust into the septum in such a manner as to 

 maintain this position. Roberts' {M. J.): I. Electro- 

 osteotomy in knock-knee, bow-legs, and anterior tibial 

 deformities. 2. Cuneiform osteotomy for hallux val- 

 gus. Robertson's {A.), for conjunctival entro- 

 pion ; a modification of Snellen's operation, in 

 which the threads are passed through the conjunc- 

 tiva at the bottom of the fold, between its palpe- 

 bral and outer portions. Robson's [Mayo), for 

 ectopia vesica?; a modification of flood's operation, 

 in which, in female subjects, the folds of integument 

 following the labia majora are detached and displaced 

 upward. Rodger's, for ankylosis of the hip; the 

 cuneiform method of osteotomy. Rogers', for 

 internal urethrotomy ; it is performed with a special 

 dilating urethrotome. Roonhuysen's, for chilo- 

 plasty. See Horn's operation. Rose's : I. For 

 double hare-lip ; the central tubercle is pared in a V- 

 shaped manner, and the lateral segments by curved 

 incisions from above downward to the muco-cutaneous 

 junction, and then obliquely upward and inward. 2. 

 For single hare-lip ; a semilunar incision is made as far 

 as the red margin of the lip, and an oblique upward 

 cut is made on either side to form the prolabium ; 

 the flaps are held in position by means of wire and 

 catgut sutures. 3. For the relief of neuralgia of 

 the fifth nerve; removal of the Gasserian ganglion. 

 Rossbach's, for tumor of the larynx; this con- 

 sists in introducing a thin knife antero-posteriorly 

 into the median line of the larynx from without, 



and amputating the tumor while the operation is 

 watched in the laryngeal mirror, held in the usual 

 position. Rotter's, for uranoplasty ; a modification 

 of Blasius' operation, in which a long cutaneo- 

 periosteal flap is taken from the forehead, passed 

 through the unclosed hare-lip, and grafted into the 

 cleft of the palate. Rouge's, for access to the nasM 

 cavities; the upper lip is freed from the jaw by an 

 incision through the mucous membrane ; the cartil- 

 aginous septum and lower lateral cartilages are then 

 detached so that the nose and lips can be raised to the 

 necessary extent. Rouse's, for proctotomy ; the mak- 

 ing of a deep incision in the fossa beside the sphincter 

 without severing the latter ; through this incision 

 the diseased portion of the rectum is pressed out 

 and excised. Routh's, for pyosalpinx ; aspiration 

 of the contents of the diseased Fallopian tube. 

 Roux's : 1. i or amputation of the foot; a modification 

 of Syme's operation, in which the flap is made chiefly 

 from the inner side of the foot. 2. For chiloplastjr; 

 after removing the diseased parts and the formation of 

 suitable flaps, the prominent portions of the superior 

 maxillary bones are removed to permit of better adjust- 

 ment of the flaps. 3. For ectopia vesica: ; closure by 

 means of flaps, one being dissected from the abdomen 

 above, and another from the scrotum below. 4. For 

 excision of the elbow ; a modification of Moreatts 

 incision, in which the inner line of the H is omitted. 

 5. For excision of the hip; it is done by raising a flap 

 from over the great trochanter. 6. For excision of the 

 tongue ; division of the symphysis menti and removal 

 of the entire tongue. 7. For hysterectomy ; temporary 

 resection of the sacrum. 8. For ligation of the 

 axillary artery ; the incision is made through the 

 delto-pectoral interval. 9. For removal of a naso- 

 pharyngeal polypus ; it is done through the upper jaw 

 by an osteoplastic operation, the whole jaw and malar 

 bone with the soft parts being turned upward and 

 outward upon the temple. 10. Elastic; a flap is 

 transferred from a distant part by successive migra- 

 tion. Roux-Sedillot's, for excision of the tongiu 

 See Roux's operation. Rudtorffer's, for 

 fingers ; division of the web after a cicatricial 

 hole has been established through it, at the root 

 of the fingers. Ruysch's, for amputation at I 

 wrist-joint ; a semilunar incision is made over the 

 dorsum of the hand ; the articulation is 

 and the anterior flap is cut from within outward 

 Rydygier's, for pylorectomy ; a vertical parietal ii 

 cision is made a little to the right of the middle line. 

 Sabatier's : I. For excision of the shoulder; a V- 

 shaped flap is raised from the deltoid region. 2. For 

 iridectomy; excision through a corneal incision as in 

 cataract-extraction. Saemisch's, lor hypopyon ulcer; 

 the cornea is transfixed and the intervening 

 including the base of the ulcer, is divided by cutting 

 outward. Saint Germain's : 1. For phimos, 

 tation of the foreskin. 2. For tracheotomy f> 

 of the larynx; rapid laryngotracheotomy ; li 

 stroke method ; the larynx is fixed between the thuml 

 and finger of the left hand, and a straight sharp 

 pointed bistoury is thrust through the cricothyroid 

 membrane. Salmon's, for fistula in ano ; in 

 which there is much induration an incision from one- 

 eighth to one-fourth of an inch deep is made along th 

 track. This is the well-known " backcut ;" it is H 

 to greatly promote healing. Sanger's, a method o! 

 performing Cesarean section ; a modification of the usual 

 operation in which the uterus is delivered through a 

 long abdominal incision before extraction of tl 

 fetus. Sanger-Leopold's, for Cesarean section 

 improved suture of the uterine wound, a deep and :i 



