Identifier: minorsurgeryband00whar ()
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he symphysis pubis, and is deepened gradually until the deep fascia is reached ; this 590 CIRCUMCISION. is divided, exposing the prevesical fat; when this is dis-placed, the wall of the bladder is exposed to view. Atenaculum is next introduced into the highest part of thevesical wall, to fix it, and a knife thrust through the wallof the bladder, the incision being carried downward aboutan inch. After the bladder is opened, forceps are intro-duced and the calculus removed. If opened for calculusand the bladder-walls are healthy, the wound may besutured with stitches which do not pass through themucous coat. The external wound is then sutured andthe bladder drained by a soft catheter passed by the ure-thra. If the bladder-walls are much diseased, the woundis left open and drainage effected by a rubber tube passedthrough the suprapubic wound into the bladder. CIRCUMCISION. Circumcision is performed by drawing the prepuce for-ward and then enclosing it in a pair of clamp-forceps Fig. 495.
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Circumcision. placed obliquely just in front of the glans (Fig. 495). Theprepuce is next divided with a straight bistoury, and the CHOLEl YSTOTOMY. 591 forceps removed, when the .skin and mneons membraneretract. The mucous membrane, if adherent, is dissectedloose from the glans; if redundant, it is trimmed withscissors to make it correspond to the line of skin incision;the cut edge of the mucous membrane is next fastened tothe cut edge of the skin by a few sutures of silk or catffiit. REMOVAL OF THE TESTICLE. In removing the testicle, a longitudinal incision is madeover the upper part of the gland and spermatic cord andthe envelopes of the testicle and cord divided; the cord isthen exposed and ligated, or the different components ofthe cord may be separated and tied independently ; thecord is divided in advance of the ligatures and the glandremoved. OPERATION FOR VARICOCELE. In operating for varicocele, the dilated veins of thespermatic cord may be ligated by a subcutaneous ligaturepa

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