The Combined Resectoscope

1961

Co.

BEHNAHD KAMHI Fro111. 1hr T>eµ11rli11enl of 811ryer!J (l.'roloyy), ;vlai111onide8 llo8pi/(l./ Hroo/;/yn, S. Y · anrl 8tute /'11i1:cr8it11 of Xew York, Oow118tlrle Medfral <'enter, Nrook/:i;n, 1\• Y. 1

Th<' rcsr>doR1·opc ha~ lwC'!l modified mnny tirnPR in order to fal'ilitak trnnwrethral n·s1,<·tio11. Two types of rl'scctosC'opt's nre in general use: I) tlw 8tern-.\frCarthy (and itc; many modifications) which generally requires the use of hoth of the ::mrgt,on's lrnm!s, arnl 2) tlw N esliit (and it~ many modificn.t,ions) 11hi('h frees ow,

sectoscope. :\.t times bleeder~ m:iy lw mun, c·oagulated when :i frl'<> haud can juxtaposP Lhrn1 tu the reseetuscope loop. \Yhil1, some surg;eon:-; c:w utilize the Stern-,\kCarthy instrmn,mi. \\'ith on1' hand, for the most part. most. mcllogist~ canuot: l:wsidcs, oue-hancl utilization of a Ntern-l\lcC:1 rthy rcsedo::;eo1w ib '.l\Yk \\'an!.

lmml ,1f I.he s11r,[(1'0ll Cur n°ctul or abdominal mnnipul:lt.io11. Each type of resectoseupc, has its prnpfmf'nts

In order to prm·id(' Lhe smgeon 11·it.h hoi.!1 mrnle~ of rP~l'ctiun with u minirn111n
and tlwre are a(hantag;et: and disadnmtag;Ps t.o the use of each. Thr: ana torny of thr, hypertrophied prostate gland is siwb that parte of it am 1uorc msily res(;ct.ed h:1· one t.1·pe of inst.rumen! and ot.l1crn are rnnn' resn:tecl by the other. Thus the lat.em! lube::; nre so sit.11aterl that it is more facile to J'C8C'('l Lhcm with the Steml\lcCarl.hy instrunwnt. The floor and Lhe wot of the hypcrtruphiccl prostu tc nrc easily mn.nipulated by n frep hand into (,h1-, path of the loop of the Nf:~bit resecto1:,1·op, Lor,,,m·er, t.he ilJlical l<1b1 s r,re easily resed,ed when a free h:wd cau manip1date t.hern into the pa.t.ll of the NeslJil. rt> 0 •

~\

1

A,·,·ep1e1l for p11l1lieatio11 Fel,nmr.v l, l~Hil

287

2ss

BERNARD KAMHI

FIG. 2

without removing the instrument from the sheath or the patient. I believe that the combined resectoscope offers the following advantages: 1) Expeditious conversion to either one- or two-hand resection. 2) The leaf type spring always keeps the loop retracted in the sheath and the danger of introducing an extended loop into the bladder is no longer present. Some fifty transurethral resections have been performed with this instrument, which has been found to be practical and convenient. The combination of rack and pinion, and leaf-type spring produces a smoothly functioning one-hand in-

strument not subject to the binding found in N esbit's and its modifications. The addition of a drop of silicon lubricant to the moving parts before resection prevents binding. Any Stern-McCarthy resectoscope may be easily converted to the combined resectoscope and the latter may be made convertible. SUMMARY

A modification of the Stern-McCarthy resectoscope has been presented that enables the surgeon to change from one-hand to two-hand cutting with ease, as his needs require.

61 Eastern Parkway, Brooklyn 38, N. Y.

FELLOWSHIP IN GENITOURINARY PATHOLOGY ,July 1, 1962 to June 30, 1963 Sponsored by the American Urological Association, Inc., at the Armed Forces Institute of Pathology, Washington, D. C., under the direction of Dr. F. K. Mostofi. Stipend, $5,000. Details may be obtained from Dr. F. K. Mostofi, Armed Forces Institute of Pathology, Washington 25, D. C.