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An ideal retractor in suprapubic cystotomy, particularly for exposure of the vesical trigon, does not exist. The chief difficulty has been to obtain a satisfactory exposure of the floor of the bladder and the ureteral orifices. Ordinarily two things occur to prevent this: First, when lateral retraction is made by simple vertical-bladed instruments, the floor and fundus of the viscus bulge up and down respectively, obscuring the ureteral orifices; second, the illumination of the operative field is either clumsy or insufficient.
The instrument here illustrated and described is essentially a Deaver retractor, or has the curve of this abdominal retractor, with certain important attachments which in my experience have made it most serviceable. The features of this new instrument are:
An adjustable cross-blade, A, which after introduction into the bladder by slight pressure at B, may be swung out as seen in A′. A set screw, S, fixes the blade
Thomas BA. A NEW BLADDER RETRACTOR. JAMA. 1915;LXV(5):421. doi:10.1001/jama.1915.25810050002014b