. American practice of surgery ; a complete system of the science and art of surgery . er-form a true plastic operation and tried tosubstitute various kinds of blind failure to extirpate the sac high up caused numerous relapses or partialrelapses, as when a scrotal hernia returned (or remained) as a the simple removal of this sac would alone be sufficient to cure manysmall hernias without any suturing ,of the canal. As the muscles and the fasciaare denuded by stripping out the sac, they would often fall together as well with-out stitches as with them, and might
. American practice of surgery ; a complete system of the science and art of surgery . er-form a true plastic operation and tried tosubstitute various kinds of blind failure to extirpate the sac high up caused numerous relapses or partialrelapses, as when a scrotal hernia returned (or remained) as a the simple removal of this sac would alone be sufficient to cure manysmall hernias without any suturing ,of the canal. As the muscles and the fasciaare denuded by stripping out the sac, they would often fall together as well with-out stitches as with them, and might unite firmh^ under the pressure of band-ages. Dr. A. J. Ochsner, of Chicago, has demonstrated that this is true infemoral hernia. It may be equally true of small oblique inguinal hernias.^Mien, however, the rings are greatly enlarged, even the Bassini suture is diffi-cult to place and of doubtful permanence. The inner margin of the dilatedorifice then extends from Hesselbachs ligament (outer border of conjoinedtendon) almost or quite to the rectus muscle. The internal and external. Fig. 2] 3.—Method of Lucas-Cliampion-ni^re. This perhaps is the earliest sug-gestion of an overlapping method, but ismore probably a crumpling up and evert-ing of layers. A similar mattress stitchwas used by Macewen. Both methods wereemployed before that of Bassini. {FromBouveret, after Lucas-Championniere.) 576 AMERICAN PRACTICE OF SURGERY. rings are dragged into line so as to form an antero-posterior opening. Onaccount of the absence or displacement of the conjoined tendon, the outeredge of the rectus sheath or muscle must be utilized in making the deepstitch. This drags the rectus outward and Pouparts ligament upward andinward, and even then one does not secure a good posterior wall for the principal element of a successful plastic operation—namely, a well-nourishedflap, without tension—is wanting. Exactly the reverse conditions are found,viz., a thin and poorly nourished flap und
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
