. Text-book of operative surgery . his way successfullyperformed end-to-end as Avell as end-to-side anastomosis both in arteriesand in veins, and has even beenable to transplant whole Organs(kidney, thyroid), and even invertthe arterio-venous circulation. According to Jacobsthal, Lambert,an Engiish surgeon, first suggestedarterioraphy, while Hallo well in 1759was the first to carry it to a success-ful issue. He closed a wound in thebrachial artery by means of a circularstitch inserted over a steel repeating the earlier experi-ments of Gluck, Postemsky andHoroch, Jassinowsky has pe
. Text-book of operative surgery . his way successfullyperformed end-to-end as Avell as end-to-side anastomosis both in arteriesand in veins, and has even beenable to transplant whole Organs(kidney, thyroid), and even invertthe arterio-venous circulation. According to Jacobsthal, Lambert,an Engiish surgeon, first suggestedarterioraphy, while Hallo well in 1759was the first to carry it to a success-ful issue. He closed a wound in thebrachial artery by means of a circularstitch inserted over a steel repeating the earlier experi-ments of Gluck, Postemsky andHoroch, Jassinowsky has perfectedthe technicjue of arterioraphy by experiments on the aorta and carotid, while Murphy and Dorfler have proved the advisability of including the intima in the suture. After Murphy had discovered the invagination method in the case of vessels which had been cut transversely, Payr perfected the technique of the Operation by •■ Technique operatoire des anastomoses vasculaires, etc., Lyon, Annais of Surgery, Feb. Fig. 71.—Techniqiie of end-to-side arterial a sketch by Cushing. SURGERY OF THE VENO US SYSTEM i6i Stripping back tlie artery wall over a small magnesium ring slipped over the proximalend, so tliat the endothelium projects and can be approximated with the endotheliumof the distal end (intussuscipiens), to which it is joined by suture. After circularresection of the femoral artery (Kümmel, 5 cm.). Murphy and Kümmel have obtainedUnion of the ends of the vessels by invagination, without interfering with the lumenof the vessel. Permanent arrest of hsemorrhage was secured in 33 out of 35 casesof lateral arterial suture. Apart from injuries, thrombosis is an equally important indication for classes of cases must be recognised. In the first the chief indication is torestore the circulation by removal of the clot, by incision of the vein, and removalof the thrombus with subsequent suture. In the second class, which is
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