OPERATIONS 



926 



OPERATIONS 



ion is made with a cataract-knife in the line of the ten- 

 don ; the probe is then passed beneath the muscle and 

 the latter is divided with scissors or knife. Sutton's 

 (It. S.), for trachelorrhaphy; the denudation removes a 

 large amount of diseased tissue, and the patency of the 

 canal is maintained. Syme's (J.) : I. A method of 

 performing amputations; the oval teg umentary flap ope- 

 ration ; a modification of the mixed amputation. 2. For 

 amputation at the ankle-joint ; a single plantar flap is 

 made, from which the os calcis is dissected out, after 

 disarticulation has been accomplished; the malleoli 

 and lower end of the tibia are then removed. 3. For 

 amputation of the thigh ; a modification of the circular 

 amputation, in which retraction of the skin is aided 

 by two lateral cuts after the usual circular incision has 

 been made. 4. For excision of the elbow ; the same 

 as Aloreau's operation. 5. For excision of the shoulder ; 

 a large posterior flap is taken from the deltoid region. 

 6. For excision of the tongue ; a modification of 

 Roux 's operation, q. v. 7. For external urethrotomy ; 

 the stricture is divided through the perineum upon a 

 grooved director. 8. For restoration of the lower lip ; 

 two large lateral flaps are dissected from the chin and 

 sides of the face and brought together in the middle 

 line. 9. For rhinoplasty ; two flaps from the cheeks, 

 with a conjoint pedicle at the root of the nose, are 

 united in the middle line. Szokalski's, for ptery- 

 gium; it is removed by means of k thread, armed 

 with two needles, so that the growth is strangulated 

 at each end and en masse between. Szymanowski's : 

 I. For the closure of an artificial anus ; it is done by 

 means of a flap of integument without any sacrifice 

 of the intestinal wall. 2. For blepharoplasty ; a mod- 

 ification of the cantho-temporal and temporo-genal 

 incisions, the former running obliquely upward and 

 outward and the latter obliquely downward and inward. 

 3. Yox ectropion of the lower lid ; excision of a triangu- 

 lar piece of skin at the external canthus, removal of a 

 part of the ciliary margin, and suture of the lid in the 

 proper position. 4. F 'or hypospadias ; a straight incis- 

 ion is made near one edge of the fistula, and the skin 

 is dissected loose ; on the opposite side of the fistula, a 

 curved flap is raised, and after the epidermis is 

 scraped off, the flap is turned under the first one and 

 secured by sutures. 5- F° r restoration of the upper 

 lip ; lateral flaps of the full breadth of the lip are cut 

 from the cheek on each side, and their inner extrem- 

 ities are brought together in the median line. 6. For 

 urethral fistula ; a flap is dissected up on either side 

 of the fistula, and one is slid under the other, the 

 under one having the epidermis removed, except at 

 the point that will lie over the fistula. Tagliacotian, 

 or Italian Method, for restoration of the nose. See 

 Tagliacozzi ' ' s operation. Tagliacozzi's, for rhino- 

 plasty; the forming of a new nose from a flap from 

 the arm secured in place, and left attached to the 

 arm until union has occurred. Tait's (Lawson) ; I. 

 For hepatotomy for hydatid cyst ; it is performed in one 

 stage and involves opening of the abdominal cavity, 

 incision and evacuation of the cyst, and the suturing 

 together of the margins of the hepatic and parietal 

 wounds. 2. Y ox lacerated perineum ; the flap-splitting 

 operation ; the recto-vaginal septum is split transversely 

 and from the extremities of this incision two lateral 

 incisions are made, running up toward the lower ter- 

 minus of each nympha and down to a little above the 

 anal orifice ; these two flaps are dissected up ; the upper 

 one is drawn toward the urethra, the lower one down 

 toward the anus; sutures are passed laterally and the 

 edges are brought together. 3. For liphoreelomy ; the 

 same as Batter s operation, with inclusion of the Fallo- 

 pian tube. 4. For oophorectomy; the pedicle is secured 



with a silk ligature and the "Staffordshire knot." 

 See Knot. Tate's, for uterine inversion ; similar to 

 Watts' operation except that one finger is also passed 

 into the bladder to act in conjunction with the fingers in 

 the rectum. Tausini's, for hepatotomy ; the cyst is 

 dissected out, and the wound in the liver is closed by a 

 double series of catgut and silk ligatures. Taylor's : 



1. For cataract-extraction ; the incision is mack- with 

 a broad needle, the capsule is lacerated and an artificial 

 pupil is made, through which the lens is extracted. 2. 

 For genu valgum due to femoral curving ; section of 

 the shaft of the femur on the outer side, a short distance 

 above the joint. Teale's : I . For amputation of the 

 arm; the long flap is placed upon the antero-external 

 aspect of the arm ; the brachial artery and the median 

 and ulnar nerves are divided with the posterior flap. 



2. F 'or amputation of the leg ; a rectangular-flap opera- 

 tion, in which a long anterior and a short posterior 

 flap are made, each consisting of both integument and 

 muscle ; the length of the anterior flap is equal to 

 half the circumference of the limb, and the posterior 

 flap is one-quarter of the length. 3. For amputation 

 of the thigh ; the same procedure as in Teale's ampu- 

 tation of the leg. 4. F 'or cataract-extraction ; removal 

 of a soft cataract by suction. 5. For lacrymal stricture : 

 slitting of the lower canaliculus and introduction of 

 different sized olive-pointed probes. 6. For symbleph' 

 aron ; two flaps of the bulbar conjunctiva are taken 

 from either side, one of which is used for covering the 

 inner surface of the lid, while the other serves as a 

 covering for the eye. Teevan's, for internal urethrtt- 

 omy ; it is done with a modification of A/aisonneuve's 

 urethrotome. Terrillon's, for hepatotomy for hydatid 

 cyst ; the portion of the liver containing the cysts is It- 

 moved by means of an elastic ligature applied after the 

 performance of celiotomy. Textor's, for excision of the 

 knee ; it is done by a curved transverse anterior incis- 

 ion, with its convexity downward. Theobald's, for 

 subconjunctival strabotomy ; it is performed after 

 Critchett's method, a " crochet-hook " being used in- 

 stead of the ordinary blunt one, to prevent the tendon 

 slipping off. Thiersch's: I. For ectopia 

 closure by means of two large lateral flaps, one to 

 cover the lower half of the defect, and the other the 

 upper half. 2. For rhinoplasty ; two lateral fla] 



the cheeks are turned over to meet in the middle line, 

 their raw surface being turned out ; a flap from the 

 forehead is then brought down and covers all. 

 For skin-grafting ; the graft is made by a to-and-fro 

 motion with a razor, shaving off as long and a 

 a section of the upper layers of the skin as is desired. 

 4. For epispadias ; the fonnation of a meatus and 

 urethra by dissection of various flaps, the enOR 

 treatment covering a period of several months. | 

 For uranoplasty ; the alveolar process is chiseled 

 away and a flap consisting of the whole thickness 

 of the cheek is turned in to close the hole ii 

 the hard palate. Thomas's (7! G.): 1. lor $.1 

 terectomy ; celiotomy with the use of the clamp ai 

 the charring of the end of the pedicle with the galvaBO- 

 cautery. 2. For laparo-elytrotomy ; removal of the 

 fetus through incisions in the abdominal wall and in th 

 vagina, without opening the peritoneum or wounding 

 the uterus. Thompson's (Sir II.) : I. For cystitis d* 

 to hypertrophied prostate; the establishment 

 manent vesical fistula over the pubes. 2. l-'oi 

 urethrotomy ; it is done with Thompson's 11101 

 of Civiale's urethrotome. 3. For vesical tumor ; tl 

 removal by a median perineal cystotomy, with tin 1 use 

 of Thompson's special forceps. Thread-operation, an 

 operation proposed by von Graefe, for regulatingw 

 position of the eyeball after tenotomy ; the thread is 



