Four months among the surgeons of Europe / by N. Senn.

  • Senn, Nicholas, 1844-1908.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Four months among the surgeons of Europe / by N. Senn. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    is a firm advocate of boutonnil-re for diagnostic and therapeutic purposes. He looks upon this operation as a trivial procedure almost devoid of danger. He introduces the drain along the groove of a Wheel- house’s gorget. He also demonstrated upon several cases the advantages of his “ whip bougie.” This in- strument is about twenty inches in length, and if pre- viously warmed is so flexible that it doubles upon itself, when fully introduced, without doing damage to the walls of the bladder. As the instrument is conical in shape, one introduction is followed by the same degree of dilatation as the introduction of a number of the ordinary filiform bougies. He favors treatment of strictures of urethra by gradual dilata- tion, and reserves the cutting operation for excep- tional cases. He is not favorably inclined to the crushing oper- ation for stone in the bladder, and showed a case of lateral operation done a few days before where the wound had almost completely healed. In plastic operations upon the urethra he performs the buttonhole operation, and drains the bladder as a preliminary measure. You can readily conceive the advantages accruing from this precaution, as it secures to the wound the two essential conditions for rapid healing: rest and the possibility of an aseptic healing. In draining the bladder he stitches the margins of the wound closely around the tube so as to prevent leakage between the drain and the soft parts. In hypospadias and epispadias he makes the new urethra by tunneling the tissues from the apex of the glans penis to the abnormal opening, and secures patency for the new channel by introducing a drain- age-tube until the healing process is completed. As a last step the abnormal opening is accurately closed over a catheter and the urethral continuity is restored. To guard against subsequent constriction of the new canal the patient is instructed to introduce a good- sized bougie at least once a week.