Operative surgery, for students and practitioners . a good deepbite even at the risk of penetrating into the mucous layer. Finallythe anastomosis is completed by tying the two threads together. OPERATIONS UrON THE SMALL INTESTINE. 427 The lines of union of the two ends of gut may be reinforced byapplying a silk Lembert suture all around. This is, however, as arule unnecessary, yet it is easily and quickly applied after the endsof the gut have been joined together as described above. The hole that is left in the mesentei-y after the segment ofgut has been resected and the ends sutured, is close
Operative surgery, for students and practitioners . a good deepbite even at the risk of penetrating into the mucous layer. Finallythe anastomosis is completed by tying the two threads together. OPERATIONS UrON THE SMALL INTESTINE. 427 The lines of union of the two ends of gut may be reinforced byapplying a silk Lembert suture all around. This is, however, as arule unnecessary, yet it is easily and quickly applied after the endsof the gut have been joined together as described above. The hole that is left in the mesentei-y after the segment ofgut has been resected and the ends sutured, is closed with severalsutures of catgut. These sutures should not be tied so tightly asto obliterate the vessels that may be included in their grasp andwhich are necessary for the supply of the gut at the line of junction. The constricting strips which were placed around the gut areremoved and the sutured bowel returned into the abdomen. Mounsells Method.—After the segment of gut has beenexcised as above described, the cut ends are placed close together. Fig. 197.—End-to-End Anastomosis. The axis of the gut restored. Theopening that still remains, less than one-third of the circumference, is closedwith a Lembert suture, using both tails of mesenteric suture in part to accom-plish this. A shows location of the mesenteric suture. B and C where theneedles are thrust through the edges of the gut preparatory to Introducing thefinal Lembert suture that closes the opening that remains. edge to edge and supported outside the abdomen upon gauze a moderately large, straight needle and fairly thick silk theedges of the cut ends of the gut are fixed to each other at fourdifferent points of their circumference equidistant from one sutures are to serve simply as tractors. The first is appliedat a point corresponding to the mesenteric attachment, the secondat a point directly opposite this, and the other two at points mid-way between these. Each of these sutures should inc
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