Modern surgery, general and operative . closed as usual. Wm. J. Mayo (Jo^r- Am. Med. Assoc,June I, 1907) reported upon 88 operations for umbilical hernia by this methodbetween 1894 and 1905; 75 were traced; i had a partial relapse; i was sup-posed to have a relapse, but operation disclosed a second opening above andoutside of the closed umbilical opening. Radical Cure of Femoral Hernia.—Cheyne ligates the neck of the sac,stitches the stump to the abdominal wall, dissects out a flap from the pec-tineus muscle, stitches this flap to Pouparts ligament and to the abdominalwall, and thus fills up t
Modern surgery, general and operative . closed as usual. Wm. J. Mayo (Jo^r- Am. Med. Assoc,June I, 1907) reported upon 88 operations for umbilical hernia by this methodbetween 1894 and 1905; 75 were traced; i had a partial relapse; i was sup-posed to have a relapse, but operation disclosed a second opening above andoutside of the closed umbilical opening. Radical Cure of Femoral Hernia.—Cheyne ligates the neck of the sac,stitches the stump to the abdominal wall, dissects out a flap from the pec-tineus muscle, stitches this flap to Pouparts ligament and to the abdominalwall, and thus fills up the crural canal. Bassini makes an incision parallel toPouparts ligament, ties the neck of the sac, cuts off the sac below the ligature,and returns the stump into the belly. He attaches by deep sutures Poupartsligament to the pectineal aponeurosis as high up as the pectineal eminence,the cord or round ligament being drawn out of the way. Superficial suturesare passed between the pubic portion and the iliac portion of the fascia Fig. 758.—Fabriciubs operation for the radical cure of femoral hernia: Neck of sac shown. Saccut away. Dotted line shows line of separation of Pouparts ligament and fascia lata (Fowler). The operation of Fabricius is very satisfactory. It is performed as fol-lows: An incision is begun over the pubic spine and is carried outward for5 inches parallel with Pouparts ligament. The sac is exposed, isolated, andopened, its contents are reduced, its neck is ligated, the sac is cut off, andthe stimap is dropped back (Fig. 758). An incision is now made belowPouparts ligament so as to separate this structure and the fascia lata, andthe flap of fascia is turned down (Fig. 759). The crural sheath and thevessels are retracted outward. The surgeon is careful not to injure theobturator artery and vein. The origin of the pectineus muscle is sutured toPouparts ligament. The lower stitches include the periosteum of the hori-zontal ramus of the pubes as well as th
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
