An improved technic of coccygectomy

Richard C Gardner

Clinical Orthopedics, 85: 143-145, 1972

Abstract by Jon Miles (the paper doesn't have one)

The method of coccygectomy given in the previous medical literature involves the surgeon placing a finger in the patient's rectum, causing a risk of deep infection of the wound. Also there is a risk of damaging the tissues of the rectum. The new [1972] method reported here doesn't involve a finger in the rectum, and avoids these risks.

The method is:

1. Place the patient in the jack-knife position [presumably with the knees drawn up to the chest - Jon]
2. Make a 7.5 cm (3 inch) cut in the skin from above the coccyx/sacrum joint down into the crease of the buttocks
3. Cut through to the coccyx, tying off or cauterising vessels that are cut through
4. Use a gloved finger to raise the tip of the coccyx
5. Cut the tip of the coccyx away from the tissues around the anus
6. Use a wet sponge to separate the rest of the coccyx from the tissues underneath it, all the way up to the coccyx/sacrum joint
7. Cut the coccyx off at the joint with the sacrum
8. If the tip of the sacrum is rough, file it down

The advantages of this method are: minimal tissue dissection; less chance of infection; avoidance of injury to the rectum; more rapid healing.