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beginning of the second piece that is covered in front, for the 

 peritoneum soon passes on to the back of the bladder, at the level 

 of the top of the vesiculas seminales, to form the recto-vesical pouch 

 and the posterior false ligaments of the bladder. The bladder is 

 readily punctured through the anterior wall of the rectum, between 

 the vesiculas seminales, without damage to the peritoneum. 



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A considerable extent of the rectum perhaps some 3 or 4 in. 

 may be removed for malignant disease, especially on the posterior 

 and postero-lateral aspect, without great risk of wounding the 

 peritoneum. At the front the peritoneum reaches to within about 3 

 or 4 in. of the anus, posteriorly it does not descend so low. In 

 excising the end of the bowel the levator ani is divided on each side, 

 and, for obtaining more room during the operation, the wound should 

 be prolonged to the tip of the coccyx. The rectum is then dragged 

 down by the vulsella. 



The muscular coat consists of an outer layer of non-striated 

 fibres arranged longitudinally, and of an inner one of circular fibres. 

 The longitudinal fibres, which in the colon are found chiefly in three 

 bands, spread evenly around the rectum in a thickish coat. Just 

 within the anus the circular fibres are aggregated in a thick band 



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