Lithotomie

Lithotomie, or lithotomy, is a surgical procedure historically used to remove stones from the urinary tract, most commonly bladder stones. The name derives from Greek lithos “stone” and tome “cutting.” In traditional practice, lithotomy involved direct surgical access to the stone, often through an incision in the perineum (perineal lithotomy) or via an incision above the pubic bone into the bladder (suprapubic lithotomy). The patient was typically placed in the lithotomy position during the procedure, a supine posture with the hips and knees flexed and the thighs abducted to provide access to the urinary tract.

Historically, bladder stones were a common indication for lithotomy, especially in regions with high stone prevalence or limited access to later technologies. The procedure could be invasive, with significant risk of bleeding, infection, and damage to adjacent structures. As medical techniques advanced, less invasive modalities for stone management emerged, notably endoscopic fragmentation and removal.

In modern urology, the term lithotomy is largely historical, replaced by more precise terminology describing the approach and site of stone removal. Techniques that have largely supplanted open lithotomy include cystolitholysis and cystolithotripsy (endoscopic fragmentation of bladder stones), transurethral or percutaneous stone removal, and extracorporeal shock wave lithotripsy for certain stones. When the term lithotomy is encountered today, it generally refers to historical descriptions or to the lithotomy position used for various procedures, rather than a current standard operation.

See also: lithotripsy, cystolithotomy, nephrolithotomy, lithotripsy.