. Manual of operative surgery. possible it will be much more difficult, time-consuming, and riskythan the methods to be described. Pylorectomy or Partial Gastrectomy.—Step- i.—Open the abdomen,usually by a longitudinal incision between the ensiform cartilage and theumbiHcus. Explore the abdomen. Step 2.—Tear a hole in the thin portion of the lesser omentum and throughthis hole feel the coronary artery as it passes in the falx coronaria (gastro- 396 THE STOMACH pancreatic fold) into the lesser omentum near the oesophageal end of thelesser curvature of the stomach. With a full curved needle pass
. Manual of operative surgery. possible it will be much more difficult, time-consuming, and riskythan the methods to be described. Pylorectomy or Partial Gastrectomy.—Step- i.—Open the abdomen,usually by a longitudinal incision between the ensiform cartilage and theumbiHcus. Explore the abdomen. Step 2.—Tear a hole in the thin portion of the lesser omentum and throughthis hole feel the coronary artery as it passes in the falx coronaria (gastro- 396 THE STOMACH pancreatic fold) into the lesser omentum near the oesophageal end of thelesser curvature of the stomach. With a full curved needle pass two ligaturesround the coronary vessels (Fig. 532) and divide the vessels between the lesser omentum except that thick portion of it called the hepato-duodenal ligament in which He the bile ducts, the portal vein, etc. ( lesser omentum is usually sufficiently divided by the tear made in itduring exposure of the coronary vessels. The portion of the omentum torn isavascular and innocent of lymph nodes.). %«li \. yJ/
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