Lithotomy from Greekfor "lithos" (stone) and "thomos" (cut), is a surgicalmethod for removal of calculi, stones formed inside certain hollow organs, such as the bladderand kidneys(urinary calculus) and gallbladder(gallstones), that cannot exit naturally through the urethra, ureteror biliary duct. The procedure, which is usually done by means of a surgical incision (therefore invasive), differs from lithotripsy, whereas the stones are crushed either by a minimally invasiveprobe inserted through the exit canal, or by ultrasoundwaves (extracorporeallithotripsy), which is a non-invasiveprocedure.
Lithotomy was a common procedure in the past. It was developed in the 18th centuryand used well until the beginning of the 20th century. Important names in its historical development were Jean Zuléma Amussat(1796-1856), Auguste Nélaton(1807-1873), Henry Thompson(1820-1904) and William Cheselden(1688-1752). The later invented a technique for lateral vesical stone lithotomy in 1727, whereupon he was said to perform the operation in about one minute time (an important feat before anesthesia).
Special surgical instrumentswere designed for lithotomy, consisting of dilatorsof the canal, forcepsand tweezers, lithotomes (stone cutter) and cystotomes (bladder cutter), urethrotomes (for incisions of the urethra) and conductors, (grooved probes used as guides for stone extraction). The patient is placed in a special position in a lithotomy surgical table, called the lithotomy position(which, curiously, retains this name until present for other unrelated medical procedures).
Transurethral lithotripsy, which was much simpler and with lower morbidity, complicationand mortalityrates, was invented by FrenchsurgeonJean Civiale(1792-1867) and largely substituted for surgical lithotomy, unless the crushing of calculi was difficult or impossible.
- Lithotomy position
- Riches E. The history of lithotomy and lithotrity. Ann R Coll Surg Engl. 1968 Oct;43(4):185-99.
- Lithotomy. Institute and Museum of the History of Science, Florence, Italy.
This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Lithotomy Wikipedia article Lithotomy.