OPERATIONS 



928 



OPERATIONS 



method of v. Graefe only in the smaller incision (less 

 than % of the circumference of the cornea) and in the 

 use of a special scoop to remove the lens. Walsham 

 and Willett's, for talipes calcaneus ; oblique division 

 of the tendo Achillis from above downward and from 

 before backward, and slipping of the ends past each 

 other and suturing. Walton's, for lacryifial stricture ; 

 slitting of the upper canaliculus into the sac, and the 

 introduction of pure silver pins. Wardrop's : I. 

 For aneurysm ; ligation of a main branch of the 

 artery distal to the aneurysm, leaving a circulation, 

 however, through another branch: 2. For entropion ; 

 ligation of a small portion of the skin by a suture 

 passed beneath. Warlomont's : I. For cataract-ex- 

 traction; a modification of the Graefe incision. 2. For 

 trichiasis ; the portion of lid in which the cilia are 

 implanted is detached, shifted upward, and fixed upon 

 the tarsus. Warren's (HI.) : I. For excision of the 

 upper jaw ; the same as Velpeau' s operation. 2. For the 

 radical cure of hernia ; the tissues of the inguinal rings 

 are injected, by means of a syringe, with a mixture 

 composed of the fluid extract of white oak, reduced to 

 a syrupy consistence, and sulphuric ether and mor- 

 phin. 3. Uranoplasty; the mucous membrane is 

 dissected up and the soft palate is freed by dividing 

 the posterior pillars, and then sutured in the middle 

 line. Waterman's, for removal of a naso-pharyngeal 

 tumor ; similar to Cheever's operation, except that the 

 hard palate is not fractured, but acts as a hinge to the 

 disarticulated superior maxilla, as in Cheever's double 

 operation. Watson's (£■), for amputation through 

 the foot ; a modification of Pirogojf s operation, in 

 which the posterior part of the os calcis is sawn off 

 and the cut is extended up behind the ankle-joint ; the 

 tibia and fibula are then sawn through from before 

 backward and downward. Watson's {P. H.): I. 

 For tarsectomy ; the joints between the astragalus and 

 scaphoid and the os calcis and cuboid are opened 

 and the metatarsal bones are sawn through from below 

 upward. 2. For goiter ; extirpation of the goiter. 3. For 

 rhinoplasty ; a modification of Fergusson's operation, 

 q. v. Watson's [Spencer) : I. For entropion; trans- 

 planting a bridge of skin from the eyelid through to 

 the conjunctival surface. 2. For trichiasis ; the wound 

 is covered by a pedunculated flap. Watts', for 

 uterine inversion ; the same as Courty ' s method ', except 

 that the fingers passed into the rectum are used to 

 dilate the inverted cervix. Weber's: 1. For cata- 

 ract-extraction ; the incision is made with a curved 

 bistoury. 2. For lacrymal stricture ; a modification of 

 Bcnuman' s operation ; slitting of the upper canaliculus, 

 subcutaneous division of the canthal ligament, and 

 dilatation by a conic silver sound and elastic cat- 

 gut bougies. 3. Plastic; the large elliptic gap is 

 closed by displacing a curved flap ; then a second 

 curved flap is displaced into the gap thus made. 4. 

 Rhinoplasty ; an oval flap is taken from the center 

 of the upper lip, consisting of only part of its thick- 

 ness, and turned up and attached to the freshened 

 edges of the defective ala. De Wecker's : 1. 

 Blepharoplasty ; a modification of Reverdin 's opera- 

 tion ; it consists in transplanting small pieces of epi- 

 dermis covered with gold-beater's skin. 2. For cata- 

 ract-extraction ; a modification of the Graefe incision in 

 cataract-extraction, and extraction without iridectomy. 

 3. For corneal or lenticular opacities ; division of the 

 sphincter of the iris by introducing forceps-scissors 

 through the corneal incision. 4. For evisceration ; a 

 suture is run through the previously loosened con- 

 junctival and subconjunctival tissue surrounding the 

 cornea, and is carried entirely around by repeated 

 punctures ; the protrusion is then cut off and the two 



ends of continuous suture are drawn together, thus 

 preventing the escape of the vitreous. 5. For glau- 

 coma ; trephining of the cornea. 6. For iridectomy : 

 an incision is made with von Graefe' s knife through 

 the cornea and iris ; the forceps-scissors is then in- 

 troduced, and a V-shaped portion of iris is removed. 7. 

 For leukomata of the cornea ; tattooing the leukomata. 

 8. For ptosis ; removal of an oval piece of skin from 

 the lid, followed by suturing of the wound. 9. l"or 

 retinal detachment ; a very fine gold wire is introduced 

 through the sclera and choroid and allowed to remain, 

 as a drain. 10. For sclerotomy ; the cataract-knife is 

 entered into the sclera, without completing the incis- 

 ion ; prolapse of the iris is thus prevented. II. For 

 staphyloma ; excision and uniting of the conjunctiva 

 over the wound. 1 2. For strabismus ; advancement 

 of Tenon's capsule, and thus of the insertion of the 

 muscle. Wehr's, for resection of the intestine ; the 

 end of the narrower part of the bowel is divided ob- 

 liquely, so that the oblong opening which results shall 

 correspond to the lumen of the other end. Weir's (A'. 

 F. ) : I. For lumbar nephrectomy ; a vertical lumbar in- 

 cision three inches from the spine, just below the twelfth 

 rib, is joined at the top by a transverse incision running 

 along the edge of the ribs. 2. Rhinoplasty ; a trans- 

 verse cut is made through the sunken nose, and the 

 tip is drawn down to the desired position, the result- 

 ing wedge-shaped gap being filled by transplanting 

 flaps from the cheeks. 3. For varicocele ; subcutaneous 

 ligation with carbolized or juniperized catgut. Wells' 

 (SirS.): I. Cholecystotomy; a modification of Sims' op- 

 eration, in which it is proposed to close the incision in 

 the gall-bladder by a continuous suture and return it to 

 the abdominal cavity. 2. Splenectomy ; the incision is 

 made through the linea semilunaris. Wells': 1. 

 For blepharoplasty of the upper lid ; dissection of the 

 cicatrix, replacement of the lid to its normal position, 

 and transplantation of a flap from the temple. 2. 

 For entropion ; splitting of the lid into anterior and pos- 

 terior leaves, excision of a fold of skin, and removal of 

 a wedge-shaped piece of the tarsus. 3. For strabot- 

 omy ; division of the tendon, subconjunctivally, close 

 to its insertion. Wenzel's : 1. For cataract-extrac- 

 tion ; in cases of total posterior synechia, a curved 

 incision is directed downward, passing through the 

 iris, and opening the lens. 2. Iridectomy ; the same 

 as Velpeau 's operation, except that the flap is removed. 

 West's, for excision of the zvrist ; two dorsal incisions 

 are made and the tendons of the thumb and fingers 

 are not divided, but are drawn aside. Westmore- 

 land's, for internal urethrotomy ; it is done with a 

 modification of A/aisonneuve's urethrotome. Whar- 

 ton's, for amputation of the foot ; a modification of 

 Teale's operation in which only one flap is made and 

 the bone is sawn off" at the level to which a short 

 flap, made according to Teale's method, would reach. 

 Wheelhouse's, for external urethrotomy ; division 

 of the stricture on a grooved probe passed through 

 the stricture from an opening made into the urn 

 in front of it. White's: I. For excision of the hip- 

 joint ; a semicircular incision is made above and behind 

 the greater trochanter, the joint is exposed ami 

 articulated, and the section made. 2. For utcrin 

 version; it is replaced by pressure by means ol a cup 

 having at its base a short staff terminating in a 

 spiral spring which rests against the operator, counter- 

 pressure being made above. White's (J. Willi* 

 for hypertrophy of the prostate ; removal of tin' testii 

 White's (O.), for the radical cure of hernia ; invagh* 

 ating the sac into the ring and plugging the latter \vith 

 an instrument devised for the purpose. Whitehead s : 

 I. For excision of hemorrhoids ; removal of a circular 



