The stamp
This stamp was issued in East Germany in 1981. It shows a lithotome (steinschnittmesser) and a hernia scissor (bruchschere). It was one of a set of stamps showing medical instruments.
The object
A lithotome is a surgical knife used during perineal lithotomy to remove bladder stones. The instrument has a concealed blade which opens when a lever is depressed on the handle. It is used to widened the perineal wound, the lithotome is inserted through the perineal wound into the bladder, the blade is opened and the lithotome withdrawn; this enlarges the wound enough to allow forceps to be passed to grasp/remove the stone.
The urology connections
Perineal lithotomy is the oldest urological operation, and is often said to be the oldest elective surgery. Descriptions are found in ancient Indian scriptures, and it is mentioned in the Hippocratic Oath.
The oldest and simplest type of perineal lithotomy is the Celsian Operation (Apparatus Minor) in England known as "Cutting on the Gripe". This was superseded by the Apparatus Major (Marion Operation), in England known as "Cutting on the Staff". The Lateral Operation followed this; this procedure is no longer carried out. Occasonally, suprapubic open lithotomy is still used, but most bladder stones are now removed endoscopically.
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