LITHOTOMY 381 



during the operation, and if the incision is sutured according 

 to the specified directions. 



OPERATION IN MARES.— In the mare the removal 

 of a vesical calculus is much more simple and is attended with 

 but little danger. It may even be performed in the standing 

 position by means of the slings, twitch, and breeding hopples. 

 The' recumbent position with general anaesthesia is, however, 

 preferable. 



Technique. — The forceps of appropriate size are intro- 

 duced into the bladder through the urethra, fixed to the stone 

 with the aid of the right hand in the vagina, and then drawn 

 upon firmly. A long, probe-pointed bistoury is then intro- 

 duced flatwise into the urethra, so its blade overlaps the 

 anterior part of the stone. As the forceps are drawn back- 

 ward the blade is turned against the urethra, which is slit 

 forward as far as is necessary to release the stone. In other 

 words, the urethra is incised forward and the stone drawn 

 backward, simultaneously, until the delivery is successfully 

 effected. No after-care is required ; the wound heals rapidly.' 

 The only untoward effect is a disturbance of urination in the 

 form of frequent attempts to empty the bladder. 



OPERATION IN DOGS. — In dogs, the prepubic opera- 

 tion should be selected on account of the small caliber of the 

 urethral tract. The bladder is reached through a median 

 line celiotomy, toward which the bladder is drawn with for- 

 ceps. The incision through the walls of the bladder is made 

 at the highest accessible point. Before proceeding .to deliver 

 the stone some pains are taken to arrest the bleeding, which 

 is always more or less copious on account of the inflamed and 

 thickened condition of the walls. The stone is removed with 

 the forceps and the incision closed with Czerny sutures of 

 No. I catgut. The abdominal incision is closed in the usual 

 manner recommended for laparotomies. 



The practice of temporarily fixing the bladder, at the in- 

 cision, to an adjacent wall in order to protect the- sutured 

 parts against contraction that would prevent healing, has 

 been adopted by White in the performance of these opera- 

 tions. 



