Operative surgery, for students and practitioners . anner as to invertthe edges of the stomach. Each stitch is drawn fairly tight. Thelower part of the opening in the stomach is left unclosed for alength sufficient to allow for the implantation, later, of the end ofthe duodenum. A second line of suture, a continuous, non-pene-trating Lembert suture of silk, is introduced. This suture invertsand buries the first line of suture, the through-and-through catgutsuture. The end of the ? stomach is wrapped in a compress andtemporarily laid aside, and the attention of the operator is directedto the du
Operative surgery, for students and practitioners . anner as to invertthe edges of the stomach. Each stitch is drawn fairly tight. Thelower part of the opening in the stomach is left unclosed for alength sufficient to allow for the implantation, later, of the end ofthe duodenum. A second line of suture, a continuous, non-pene-trating Lembert suture of silk, is introduced. This suture invertsand buries the first line of suture, the through-and-through catgutsuture. The end of the ? stomach is wrapped in a compress andtemporarily laid aside, and the attention of the operator is directedto the duodenum. The duodenum is divided between the two clamps, rather close tothe crushing clamp, and the resection of the pylorus is thus accom-plished. The end of the duodenum that protrudes between the blades OPERATIONS UPON THE STO^L^CII. 389 of the rubber-sheathed holding clamp is wiped clean with a gauzecompress. After the protecting gauze pads have been renewed the end of theduodenum is sutured into the opening that has been left in the Fig. 179.—Restoration of the Gastro-intestinal Canal, Billrotlis First posterior half of the non-penetrating, outside serous ring suture hasbeen applied. The end of the duodenum is Joined to the margin of the opening in thestomach with a continuous non-penetrating suture of silk. This suturecatches the wall of the duodenum about one-quarter inch beyond itscut edge and Joins it to the wall of the stomach about one-quarter inchaway from the edge of the opening. This suture is applied only half-way around (the posterior half) and then the needle is laid aside 390 ABDOMEN AND BACK. until required later to complete this outside ring of suture. With athrough-and-through sutvire of chromic catgut the edge of the duo-denum is accurately sewed all around to the edge of the opening inthe stomach. After this line of suture has been completed the needlecarrying the silk thread with which the posterior half of the outside,non-penetrati
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