Operative surgery . s of safe practice. Theoblique intramuscular separation [e)exposes the patient to the minimumdanger of hernial sequels, the vertical {d)and the free oblique to the modified methods of approach to theseat of disease will be considered as theconditions demanding their adoption ap-pear. The Treatment of the Appendix.—The appendix should always be removedwhen consistent with the welfare of thepatient. If adherent, it should be cau-tiously separated from its connections,from the base downward or apex up-ward, as convenience and care may dic-tate, observing that no po
Operative surgery . s of safe practice. Theoblique intramuscular separation [e)exposes the patient to the minimumdanger of hernial sequels, the vertical {d)and the free oblique to the modified methods of approach to theseat of disease will be considered as theconditions demanding their adoption ap-pear. The Treatment of the Appendix.—The appendix should always be removedwhen consistent with the welfare of thepatient. If adherent, it should be cau-tiously separated from its connections,from the base downward or apex up-ward, as convenience and care may dic-tate, observing that no portion of it re-mains behind. Its mesentery should betied with catgut in one or more sec-tions, then divided wath scissors, and theappendix, raised up along with the wall of the csecum into the wound,isolated by aseptic surrouiulings, and perhaps caught with forceps orloosely with a ligature, close at the base (Fig. 925), should be cut off abouthalf an inch from its oriscin and a sleeve of serous membrane turned V^. Fio. 025.—Fowlers treiitinent of ap-pendix, showing base caught byligature, distal ligature to preventescape of contents, and line indi-cating division of the mucous mem-brane. 714 OPERATIVE SURGERY. i;p (Fig. 926). The patency of the lumen of the stump is then establishedbefore the ligature is applied by the introduction through it into thecfficum of a probe (Fig. 922, q). The stump may be treated by one of thefollowing methods: a. By drawing the serous coat over the ends of the inner structures anduniting it there with fine silk or catgut. h. By suturing together the outer and middle coats after removal of theinner (mucous) by cutting or cautery. c. By depressing a short, flexible stump into the wall of the caecum () and burying it there by joining together with sutures the borders of thecaecal depression (Fig. 928). d. By severing the stump close to the csecum, inverting the bordersand uniting them as before with sutures. e. By destroying the mucous lin
Size: 1243px × 2011px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
