. Operative gynecology. ncludingall its vessels; the mesen-teriolum is then cut throughdown to the root of the ap-pendix. A circular incisionis now made through theperitoneum surrounding theappendix about 2 eentune-ters from the large bowel,and by pulling on its lowerend and using the point ofthe knife or a little bluntinstrument to peel back thepeiitoneum, a cuff 1 centi-meter long is turned uponto the colon. The mus-cular and mucous coats arenow tied tightly with finesilk close under the reflectedcuff and close to the co-lon, and another ligature isplaced lower down aftermilking back its con
. Operative gynecology. ncludingall its vessels; the mesen-teriolum is then cut throughdown to the root of the ap-pendix. A circular incisionis now made through theperitoneum surrounding theappendix about 2 eentune-ters from the large bowel,and by pulling on its lowerend and using the point ofthe knife or a little bluntinstrument to peel back thepeiitoneum, a cuff 1 centi-meter long is turned uponto the colon. The mus-cular and mucous coats arenow tied tightly with finesilk close under the reflectedcuff and close to the co-lon, and another ligature isplaced lower down aftermilking back its contents,so as to prevent any escapeof fecal matter upon sever-ing the appendix. The ap-pendix is now divided halfa centimeter beyond the proximal ligature. The free end is removed or the endadhering to the tumor is carefully wrapped in gauze and dropped for a stump shows a small tract of everted mucosa pouting beyond its ligature;this is cleansed with a bit of cotton and sterilized with pure carbolic acid, taking. Fig. 559.—Secoxi) Step in the Operation eok mesenteriolum cut through and the peritoneum and exter-nal muscular coat of the appendix circumcised. 500 INTESTINAL COMPLICATIONS. care not to let any of it run onto the peritoneum. The i-eflected peritonealcuii is now drawn down over the little stump and tm-ned in so as to bring the peritoneal margins together,when it is sutured fromside to side with a continu-ous overlapping fine silksutui-e threaded in a straightneedle. The stump of theappendix now appears likea little tit on the cecum, orit lies almost hidden be-tween the cecal folds. Theend of the appendix isfinally completely put outof sight in an extraperito-neal pocket by a catgut su-tui-e catching it and pass-ing through the sides of thelittle triangular opening atthe base of the mesenteri-olum; upon tying the su-ture, the stump is drawndown between the layers ofthe peritoneum, which arealso apjjroximated at thesame time. In some cases w
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
