Surgery; its theory and practice . and at the sametime invaginate the ring-lined proximal portion of the intestineinto the distal portion (Fig. 130) to the extent of the whole widthof the ring. Tie the sutures only sufficiently tightly to preventdisinvagination. The two peritoneal surfaces are thus held inclose contact by the rubber ring. The intestinal contents, saysSenn, pass freely through the lumen of the ring from above down-wards, and escape from below is impossible, as the free end of theintussuscipiens secures accurate valvular closure. The catgutsutures fixing the ring are absorbed, a
Surgery; its theory and practice . and at the sametime invaginate the ring-lined proximal portion of the intestineinto the distal portion (Fig. 130) to the extent of the whole widthof the ring. Tie the sutures only sufficiently tightly to preventdisinvagination. The two peritoneal surfaces are thus held inclose contact by the rubber ring. The intestinal contents, saysSenn, pass freely through the lumen of the ring from above down-wards, and escape from below is impossible, as the free end of theintussuscipiens secures accurate valvular closure. The catgutsutures fixing the ring are absorbed, and the ring, reconvertedinto a band, is passed per anum. The invagination sutures arebelieved by Senn to be removed by substitution on the part of thetissues. Hence the punctures of the bowel remained closed andextravasation is prevented. MaunselPs method.—Bring the twoends of the divided bowel together by two temporary suturespassed through all the coats, one suture at the mesenteric attach- FiG. 131. iJU^i4^jt:s:^jWj5itmjvilJ. Maunsells method of circular enterorrhaphy. a n c. rcritoneal, muscular and mucous Mesentery, d d. Temporary sutures uniting proximal and distal portions ol dividedintestine, and passed out througli longitudinal slit made in the proximal or larger segmentin the intestine. ment, the other opposite. The mesenteric suture should closethe little triangle where the mesentery is reflected from the the long ends of the sutures intact. Pass them up thelumen of the proximal portion of the bowel and out through alongitudinal slit previously made in its wall opposite the mesen-tery, and about an inch from its cut end (Fig. 131). Draw on maunsells method. 385 the sutures, and the distal or smaller end g (Fig. 133) will beinvaginated into the proximal or larger end h, and thence pulledout of the longitudinal incision in the wall of the proximal portionH. From Fig. 132 it will be seen that the serous surfaces of thetwo portions are in accurate ap
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
