. Manual of operative surgery. the stomach.) Replace the pylorus in the abdomen. Do not suture the wound in thepylorus. Close the abdomen. Strauss Operation.—Open the abdomen and deliver the tumor as in theFredet-Rammstedt operation. With a knife make an incision over the mostbloodless part of the tumor throughout its whole extent. Only cut the super-ficial layers of the musculosa. With the handle of the scalpel split the rest ofthe musculosa at the stomach end of the tumor, until the submucosa isreached. From this point continue the splitting of the muscle down to theduodenal end of the tumor
. Manual of operative surgery. the stomach.) Replace the pylorus in the abdomen. Do not suture the wound in thepylorus. Close the abdomen. Strauss Operation.—Open the abdomen and deliver the tumor as in theFredet-Rammstedt operation. With a knife make an incision over the mostbloodless part of the tumor throughout its whole extent. Only cut the super-ficial layers of the musculosa. With the handle of the scalpel split the rest ofthe musculosa at the stomach end of the tumor, until the submucosa isreached. From this point continue the splitting of the muscle down to theduodenal end of the tumor. Should the mucosa be accidentally opened closeits wound by a few catgut stitches. Seize the edges of the split tumor withfingers and thumb and spread them apart like opening a book (Fig. 508).Be sure that every muscle fiber of the tumor is separated down to theduodenum. With a blunt instrument separate the mucosa from the musculosauntil the former is entirely free. Make a flap of musculosa with its hinge at 378 THE STOMACH.
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