Operative surgery . pyloric end of thestomach during digestion (page 750) suggests the wis-dom of making the anastomosis at this situation when])racticable. The employment of valvular flap de-vices for the purpose is less reliable, more difficult andcomplicated than that of the Murphy button, thebone bobbin, and other similar agents. Entero-((naf<tomofiis with the Murphy button canbe quickly carried into effect—after opening the in-testine for union with the stomach—by introducingthrough the opening, by means of ordinary forceps((Jallet) (Fig. 982), or forceps devised for the pur-pose (Turn
Operative surgery . pyloric end of thestomach during digestion (page 750) suggests the wis-dom of making the anastomosis at this situation when])racticable. The employment of valvular flap de-vices for the purpose is less reliable, more difficult andcomplicated than that of the Murphy button, thebone bobbin, and other similar agents. Entero-((naf<tomofiis with the Murphy button canbe quickly carried into effect—after opening the in-testine for union with the stomach—by introducingthrough the opening, by means of ordinary forceps((Jallet) (Fig. 982), or forceps devised for the pur-pose (Turnure), a segment of button into each limbof the intestine in such a manner that, when closedby opposing pressure, the stems of the segmentspenetrate the intervejiing tissues and complete theanastomosis when locked. The Results.—MuiyJiy reports with the use of his button, entero-en-terostomies, 550 cases; 543 reported results, with 415 recoveries, or cent; deaths, per cent (written communication).. Fig. 983.—The operationof cntero-anastomosis,Gallets method, withordinary forceps. modification ofstem of Murpliys but-ton. 766 OPERATIVE SURGERY. The Eemarlcs.—The careful evacuation of the stomach and intestinesbefore operation is a wise precaution, and a time-saving measure duringoperation, as the tendency to and danger of infection is lessened by thismeans. Preparatory stimulation and strengthening of tlie patient is advis-able when the already de})ressed state demands it and time will permit. Thecontinued regurgitation into the stomach of the intestinal contents is delete-rious in an extreme degree, and should be combated by lavage, medication,and posture. The median abdominal incision is commonly employed in thisoperation. If freer exposure of the parts is desired, this incision may be sup-plemented by a transverse one three or four inches in length made at rightangles with the former. Union by Halsteds method of sewing is more secureand promptly
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