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  method reported here doesn't involve a finger in the rectum, and avoids these risks.
The method is:
- Place the patient in the jack-knife position [presumably with the knees drawn up to the chest - Jon]
- Make a 7.5 cm (3 inch) cut in the skin from above the coccyx/sacrum joint down into the crease of the buttocks
- Cut through to the coccyx, tying off or cauterising vessels that are cut through
- Use a gloved finger to raise the tip of the coccyx
- Cut the tip of the coccyx away from the tissues around the anus
- 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
- Cut the coccyx off at the joint with the sacrum
- 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.