. Annals of surgery. testine which embraces themesenteric insertion. It is scarcely necessary to dwell uponthe further steps of the operation, since they are merely acombination of those given in end-to-end and lateral anas- C26 WILLARD BARTLETT. tomoses. The posterior row approximates the two viscera,being inserted after the continuous Connell method, while theanterior row is again made after the manner of using theneedle next the reader in Fig. 2. The resulting ends of threadare tied as in Fig. 4, and the operation is complete. This form of suture has been found equally well applicablewherev
. Annals of surgery. testine which embraces themesenteric insertion. It is scarcely necessary to dwell uponthe further steps of the operation, since they are merely acombination of those given in end-to-end and lateral anas- C26 WILLARD BARTLETT. tomoses. The posterior row approximates the two viscera,being inserted after the continuous Connell method, while theanterior row is again made after the manner of using theneedle next the reader in Fig. 2. The resulting ends of threadare tied as in Fig. 4, and the operation is complete. This form of suture has been found equally well applicablewherever tried and, as the following list will show, its use hasmet the widest possible indications in end-to-end, lateral, andend-to-side anastomoses. The stomach has been connectedwith the small bowel anteriorly as well as posteriorly by thelateral method as well as end-to-side in the Roux bowel has been connected with small bowel by both thelateral and end-to-end methods. The small bowel has been Fig. united with the large bowel, not only laterally but gall-bladder has been anastomosed into the stomach in oneinstance and in another into the large bowel. Not only hasthis method been used in seemingly normal viscera but on thosechanged by disease in almost every conceivable manner. Ithas proven its value in a distended gut above an acute obstruc-tion, also in the oedematous condition associated with acuteperitonitis. It has been equally successful in the compensatorythickening associated with chronic obstruction. After resection of the head of the ascending colon, therehas been practically no difficulty in making end-to-end anas-tomosis between the ileum and colon of vastly different diame-ters. To illustrate the ease and speed with which the method SUTURING HOLLOW VISCERA. 527 can be applied, it is enough to state that a double resection withdouble anastomosis has been accomplished in about the sametime that the single operation of this sort forme
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
