The Great Surgical Operat...
The Times, 1824-01-19T00:00:00

LFrom The Lancet of Saturdav.] Guy's Hospital, jan. Ii. This formidable operation was performed here this morning for the first time, by Sir Astley Cooper, in the presence of some of the surgeons and pupils belonging to these institutions. The number of those present, however, was not so great as on many other occa- sioins, no previous notice of the operation having been given, and this arose in consequence of it not having been determined on but a few minutes before its performance. The patient is a man about 40 years of age, whose leg had been amputated some years ago, just above the knee, since which time the thigh bone had becomc diseased from the extremity of the stump, up to the tro- chanter major; and this disease has had such effect on him of late, that he has been rapidly sinking under it; the thigh was of the middle size. On being asked tnis morning to submit to an onera- tion,bereadily conserited. Athalf-past one the patient was br6uglt into the operating theatre, and placed in the recumbent posture on the table; the femoral artery, being tightly compressed at the roin by an assistant (Dlr. Key,) Sir Astley, standing to the outer side, with the limb in one hand, and the cadin in the other, com- menced the operation, hy making an incision just below Poupart's ligaente, a little to the iliac side of the femoral artery ; this was continued obliquelv downwvards antl outwards to the backt of the thigh, about one.third of the way dov.n, from which point the knife was carried in the opposite direction, oblinuely upwards and inwards to meet the first incssion, bz this means forming an elliptical curve. At this step of the operation, the femoral arterv was divided, to which a ligature was immncdiately applied ; the'skin and cellular membTane were merely cut through at first, but the knire was again carried in the same direction as before, and thus the muscles were also separated: at tdis step also, it was necessarv to apply an- other ligature; bere the operator changed positions, and sat on a thair in front of the patient, and waited a short time to see whether there were any bleeding vessels; after the lapse of a few minutes the operation was contitued, and very shortly completed, the bead of the thigh-bone being removed from the acetabulum without any difli- culty. Two ligaturesin addition to those already used were applied, making in the whttdo four; the integunments were brought together, and a suture applied to the upper portions; strips of adhesive plaster, and lastly a band e, were put over the stump. Tbere were about 12 ounces of blood lost, but it had the appearance of being venous. The limb was removed in the space of 20 minutes, the securing the arteries and dressing occupied fifteen more; thb whole was complet. ecd hi 35 minutes. During the overation thb man was extremely faint, bitt sone wine being given him, and fresh air admitted, he reco- vered. He bore the oneration with extraordinary fortitude, and after all was finished, siid to Sir Astley, " that it was the hardest day's work lie bad ever gone tlhrough," to which Sir Astley replied, " that it wias almost the latdest he ever had," THE GRPAT SURGIAL. OPERATIO7N OF R?E. I.N"G A4 THIGH AT_THrE Hip JO-INyT.