. American practice of surgery ; a complete system of the science and art of surgery . his manoeuvre is facihtated by the looseattachment of the pleura to the pericardium andby the finii connections which exist between thepleura and the triangularis stemi. The pericar-dium is opened with a knife at its lower part afterit has been elevated with forceps, and the incisionis then enlarged from below upward with more room is needed the fourth costal cartilagemay be resected. Durands operation is a combination of that ofOlher and that of Delorme and Mignon. Afterthe fifth costal cartilag
. American practice of surgery ; a complete system of the science and art of surgery . his manoeuvre is facihtated by the looseattachment of the pleura to the pericardium andby the finii connections which exist between thepleura and the triangularis stemi. The pericar-dium is opened with a knife at its lower part afterit has been elevated with forceps, and the incisionis then enlarged from below upward with more room is needed the fourth costal cartilagemay be resected. Durands operation is a combination of that ofOlher and that of Delorme and Mignon. Afterthe fifth costal cartilage has been resected, asrecommended by Oilier, the internal mammaryvessels are ligated at the upper and lower bordersof the wound, in order that they may not bewounded during the operation or give rise to sec-ondary hemorrhage by ulceration at a later period,placed outward as in the Delorme-Mignon operation,owing to inflammatory adhesions,—and such is frequently the case,gouges away a portion of the sternum. Voinitch-Sianojentzky, from studies made on the cadaver, recommends three. Fig. 66.—Pericardotomy ac-cording to Delorme and ^Mignon.(Terrier and RejTnond, Chi-rurgie du eceur et dupericarde,Paris, 1898.) The pleura is then dis-When this is impossible,-Durand THE PERICARDIUM, HEART, AND BLOOD-VESSELS. 159 different operations, according to the amount of fluid present. Inasmuch as theamount of fluid present can rarely be foretold before operation, we believe that itis useless to describe these operations. If excision of a portion of the thoracic wall becomes necessary, we are inclinedto think that the chondroplastic flap suggested by Roberts is better than theremoval of one or two costal cartilages. The Roberts operation consists inmaking a trap-door out of portions of the fourth and fifth costal cartilages, thesoft tissues of the third interspace being utiHzed as a hinge upon which the doormay be turned upward. An incision is first made along the left border of thesternum
Size: 1434px × 1742px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
