LITHOVOMY (Lat. lithotomia, from Gk. Moro/Ala, lithotomy, from NtOos, lithos, stone + row', a cutting, from TIAVEtr, to cut). The technical name for the surgical opera tion popularly called rooting for stony.
As most of the symptoms of stone in the blad der (see CALCULUs) may be simulated by other diseases of the bladder and adjaecnt parts, it is necessary to have additional evidence regarding the true nature of the ease before resorting to so serious an operation as l it hottony. This resorting_ dence is afforded by sounding the patient—a shn ple preliminary operation, %Odell consists in in troducing into the bladder, through the natural urinary passage (the urethra), a metallic in strument, by means of which the -tone can be plainly felt and heard. From the shortness of the female urethra and the extent to which it can he dilated, and, additionally, from the compara tive rarity of ealculous affections in women, the operation of lithotomy is almost exclusively re stricted to the male sex.
Lithotomy has been performed in various ways at. different times. earliest form of lith otomy is known as cutting on the gripe, or celous's method. It received the former name from the stone, after being fixed by the pressure of the fingers in the anus, being directly out upon and extracted; and the latter. from its having been first described. so far as is now known. by Celsus, although it had probably been practiced from time immemorial. At a later period this operation received from Mari anus the name of the apparatus minor (from a knife and hook being the only instruments used), to distinguish it from his own method, which he called the apparatus major, from the numerous instruments he employed. The Marian method
was founded on the erroneous idea that wounds of membranous parts would not heal, while their dilatation was comparatively harmless. The ob ject was to do as little as possible with the knife, and as much as possible with dilating instru ments; mid the necessary result was laceration and such other severe injury that this became one of the most fatal operations in surgery. Nevertheless, it was the operation mainly in vogue for nearly :100 years. At present, surgeons, operating by cutting through the perineum (the body between the rectum and the bladder), use a median, or a lateral. or a slightly curved trans verse incision. according to individual preference. But either of these methods is suitable only for the removal of a small stone; therefore it is most frequently advisable to remove the calculus by an abdominal ineision ( supra pubic lit hot only .1% hieh was first employed by Franco in 1561. By this method the opening is made first above the nulics, ond the bladder is entered without rutting the peritoneum. For details of the operation and of after-treatment. consult Dennis and Billings. .t system of Surgery (Phil:Idyll Ida.