. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. hy open the sac ?. There is no indicationfor such a proceeding ; while, on the other hand, the obviousadvantages of omitting it are that we avoid exposing the pro-truded parts to the air, and escape the risk of wounding them;moreover, I shall show that, in respect to the consequence ofthe operation, it is desirable that the sac should not have been KELOTOMY OR HERNIOTOMY. 223 opene
. Hernia, strangulated and reducible. With cure by subcutaneous injections, together with sugcested [!] and improved methods for kelotomy. Also an appendix giving a short account of various new surgical instruments. hy open the sac ?. There is no indicationfor such a proceeding ; while, on the other hand, the obviousadvantages of omitting it are that we avoid exposing the pro-truded parts to the air, and escape the risk of wounding them;moreover, I shall show that, in respect to the consequence ofthe operation, it is desirable that the sac should not have been KELOTOMY OR HERNIOTOMY. 223 opened. From these several considerations I conclude that itis better to enlarge the ring on the outside than from the insideof the sac. In all these arguments he is sustained by SirAstley Cooper, who frequently in practice and in lecture advo-cated the method. Petits operation was as follows. Dissecting down to the sac,where it passes out from the ring, he insinuated between thering and the sac a flat grooved director curved toward its bistoury carried along the groove divided what was thusraised. If this division be not sufficient, it may be repeateduntil sufficient space has been made to allow »?? Fio. 50.—Direct Inguinal Hernia. Mr. Key recommends in inguinal hernia a mode, of proceed-ing by which the surgeon may be enabled to divide the strictureeither at the internal or external ring. He makes an incisionof an inch and a half over the neck of the tumour, so as to laybare the lower portion of the external oblique tendon, where itforms the ring. A small opening should then be made in thetendon just above the ring : by introducing the director it willbe found whether the stricture is at the lower or upper the former case the director is carried under the margin ofthe tendon, which is then divided to a sufficient extent. If the 224 HERNIA. stricture should be at the upper opening, the incision in theaponeurosis of the obliquus externus must be enlar
Size: 1603px × 1558px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, bookpublisheretcetc, bookyear188
