Lithotomy

Surgical method for removal of stones

Lithotomy

Illustration of a lithotomy procedure

Lithotomy is a surgical procedure for the removal of calculi (stones) from the urinary tract, including the kidney, ureter, bladder, and urethra. The term is derived from the Greek words "lithos" meaning "stone" and "tomos" meaning "cut".

History

The practice of lithotomy dates back to ancient times, with evidence of the procedure being performed in ancient India and Greece. The Hippocratic Oath even includes a clause that advises physicians to "leave the cutting of the stone to those who are practitioners of this work."

Procedure

Lithotomy involves making an incision in the body to access the stone. The specific approach depends on the location of the stone:

• Nephrolithotomy: This is performed to remove stones from the kidney. It involves making an incision in the flank to access the kidney directly.
• Ureterolithotomy: This procedure is used to remove stones from the ureter. An incision is made in the abdominal or flank area to access the ureter.
• Cystolithotomy: This involves removing stones from the bladder. An incision is made in the lower abdomen to access the bladder.
• Urethrolithotomy: This is performed to remove stones from the urethra.

Modern Techniques

In modern medicine, lithotomy has largely been replaced by less invasive techniques such as extracorporeal shock wave lithotripsy (ESWL), ureteroscopy, and percutaneous nephrolithotomy (PCNL). These methods reduce the need for open surgery and have shorter recovery times.

Complications

As with any surgical procedure, lithotomy carries risks of complications, including infection, bleeding, and damage to surrounding tissues. Advances in surgical techniques and postoperative care have significantly reduced these risks.

Position

The term "lithotomy position" refers to a common position used in various surgical procedures, including gynecological and urological surgeries. In this position, the patient lies on their back with the legs flexed 90 degrees at the hips and knees, often supported by stirrups.

Related pages

• Urology
• Nephrology
• Surgery
• Kidney stone disease