. A manual of operative surgery . well adapted for suturing, but it is all-important that food should pass from the stomach into theupper end of the gut so that digestion may be properly carriedout. Thus, whatever method be employed, the surgeon mustfirst find the termination of the duodenum, which is fixed infront of the aorta behind the transverse colon. The demon-stration of the commencement of the jejunum is best effectedby drawing the transverse colon upwards and by then passingthe fingers along the under-surface of the transverse meso-colonuntil the vertebral column is reached. Just to t
. A manual of operative surgery . well adapted for suturing, but it is all-important that food should pass from the stomach into theupper end of the gut so that digestion may be properly carriedout. Thus, whatever method be employed, the surgeon mustfirst find the termination of the duodenum, which is fixed infront of the aorta behind the transverse colon. The demon-stration of the commencement of the jejunum is best effectedby drawing the transverse colon upwards and by then passingthe fingers along the under-surface of the transverse meso-colonuntil the vertebral column is reached. Just to the left of the CHAP. Ill] GASTRO-JEJ UNOSTOMY 207 spine the terminal part of the duodenum will be will lead to the jejunum, and traction upon the coil seizedwill demonstrate that it represents the very commencement ofthe jejunum. It is important to favour, as far as is possible, the contentsof the stomach passing into the descending limb of the jejunalloop. For this reason, the intestine should be so sutured that. fig. 60.—posterior GASTROJEJUNOSTOMY. (From Hartmanns Chirurgie Gastro- Intestinale.) The transverse colon is raised and part of the stomach has been drawn through an aperturemade in the transverse meso-colon. The loop of the jejunum has been fixed to thestomach obliquely, the opening made between the two organs is being evenly secured allround by a continuous suture of silk. its axis may correspond with that of the stomach— bothrunning from left to right. Further, the direction of the loopsecured should be obliquely downwards. This will be readilyunderstood by reference to Fig. 62. The jejunum is fixed to the stomach for a length of aboutthree inches, the central two inches representing the actualaperture of communication. The fixation of the two in eitherside of the aperture ensures the absence of kinking. 208 ABDOMINAL OPERATIONS [PART II Instruments Required.—These are of a simple kind, andno special instruments are needed besides a pair
Size: 1795px × 1392px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
