A rare and early hinged gorget dating to the 18th century

The term gorget was a medieval  term referring to a steel or leather belt which protected the neck. The urological term referred to a grooved steel instrument used to direct instruments into the bladder during lithotomy (literally cutting for a stone) when removing or destroying bladder stones.

The advantage of the hinge is that it creates an instrument that not only acts as a guide for the forceps to extract the calculus, but also allows the operator to spread the incision significantly by squeezing the handle. Thus larger stones can be extracted without having to extend the incision, which saves time and reduces bleeding (with thanks to Prof Engel Medical historian and urologist for this information).

The French 18th C surgeon Le Blanc who practised in Orleans used such a gorgeret dilatoire to similar effect and this instrument may also have been used for the surgical treatment of hernias.

A similar instrument in the Boerhaave Museum is dated to 1650.

• From the Phisick collection