Modern surgery, general and operative . e insertion of the linea transversae,one of which is found about midway between the ensiform cartilage andumbihcus and is crossed by this incision. The attachment of the muscle to Cholecvstostomv 112: the anterior wall of its sheath is very close at this linea transversa, and requiressharp dissection vrith knife or scissors. \Mien the muscle is thoroughly freed from its sheath except at its outerborder, it is easily retracted outward and allows the posterior wall of its sheathand the peritoneum to be incised in the same direction as the skin and ante-rio
Modern surgery, general and operative . e insertion of the linea transversae,one of which is found about midway between the ensiform cartilage andumbihcus and is crossed by this incision. The attachment of the muscle to Cholecvstostomv 112: the anterior wall of its sheath is very close at this linea transversa, and requiressharp dissection vrith knife or scissors. \Mien the muscle is thoroughly freed from its sheath except at its outerborder, it is easily retracted outward and allows the posterior wall of its sheathand the peritoneum to be incised in the same direction as the skin and ante-rior wall. The upper end of this diagonal incision through the posteriorwall extends into the short, transverse incision across the Knea alba, ^^^lenthis last cut is made the incision pulls open and gives ready access to theright upper abdomen. This incision does not damage the intercostal ner\^es,hence muscular atrophy is avoided. The opening through the differentplanes of the abdominal wall are not continuous, hence closure will be more. Fig. 725.—A, Anterior wall of sheath of rectus muscle; B. posterior wall of sheath: C, rectus muscle;D, intercostal ner\-es. The direction of the incision through the skin, fat, and anterior wall of thesheath of the rectus muscle (Collins). solid. The opening in the posterior portion of the rectus sheath is protectedby iminjured muscle. Cholecystostomy or, as many call it. cholecystotomy,^ is the oper-ation of opening and draining the gall-bladder in order to extract gall-stonesor secure the removal of infectious material. In the hands of the Mayosoperations for stone exhibit a mortaht} of less than i per cent.; Kochers mor-tality is 2 per cent. WTien death follows an operation on the gall-bladder orducts, in about one-half the cases it is due to duct infection and is precededb^ grave nenous s}Tnptoms (]\Iayo). Cholecystostomy is performed in casesof acute cholecystitis, in hydrops, and in empyema of the gall-bladder: in gall-stone cases in wh
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
