. American practice of surgery ; a complete system of the science and art of surgery . s method for establishing a lateralanastomosis, between a loop of the sigmoid and the rectum, by means of aMurphy button. (Fig. 341.) This method is apphcable in cases where thestricture is at the upper end of the rectum or in the lower extremity of the sig- SURGICAL DISEASES OF THE AXUS AND RECTUM. ) moid. After the button has cut its way through the bowel, a long clamp isintroduced into the lower part of the rectum, and one blade of it Is pushed thi-oughthe stricture into the upper part of the rectum
. American practice of surgery ; a complete system of the science and art of surgery . s method for establishing a lateralanastomosis, between a loop of the sigmoid and the rectum, by means of aMurphy button. (Fig. 341.) This method is apphcable in cases where thestricture is at the upper end of the rectum or in the lower extremity of the sig- SURGICAL DISEASES OF THE AXUS AND RECTUM. ) moid. After the button has cut its way through the bowel, a long clamp isintroduced into the lower part of the rectum, and one blade of it Is pushed thi-oughthe stricture into the upper part of the rectum and the other through the open-ing made by the button into the lower leg of the anastomosing loop. () The clamp is then closed and allowed to remain until it cuts its waythiough the septum. By this means the cahbre of the rectimi \^ill be increasedto that of the combined calibres of the sigmoid and the strictured portion of therectum. Bacon states that, when the stricture is situated low down, the oper-ation may be done by the sacral method. Kelly, of the Jolms Hopkins Hos-. FiG. 344.—Kellj-*s Eiitero--\iiastoinosis. Second Stage. (Tuttle, op. cit.) pital, has reported a case successfully operated upon by a somewhat similarde^ice, but without the aid of a ^lurphy button or any other mechanical de\ice.(Figs. 343 and 3-i4: see also Colorectostomy. p. 922.) (Kellj-s OperativeG^Tiiecolog}. p. olo.) Colostomy.—Until recently colostomy for the relief of a non-mahgnantstricture of the rectmn was done only as a last resort, as when complete ob-struction was imminent or when the pain from the obstruction had becomeunbearable. However, since improved methods and better technique havebeen introduced, the operation is highly recommended in cases where the strict-ure is inoperable by excision or by proctotomy, and also when it has recurred 856 AMERICAN PRACTICE OF SURGERY. after these operations, or where complete obstruction is inevitable. Still morerecently, a temporary inguin
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