. Manual of operative surgery. Fig. 607. 2. Intussusception withdrawn. 3. Pack in distal end gut. S. Circular incision of middle layer in-tussusceptum. 5. Forceps on vessels. 6, 7. Ileum divided between clamps. 8. Completion of primaryincision. (Coffey, Annals of Surgery.) d/sT/iL e//i> or luuM \ 3 10 11 fW/ff/iAr/Mien fttinr iu/t/fieo \ fnuiiat iw MfiSMotii pnO/IH/IL CND OF /L£U/f. f{ C. Corrcr Fig. 608. 9. Partial suture distal and ileum. 10. Mesentery ligated. 11. Division of mesentery. 12. Proximalgut closed. (Coffey, Annals of Surgery.) INTUSSUSCEPTION 449 to it. It will probably be be
. Manual of operative surgery. Fig. 607. 2. Intussusception withdrawn. 3. Pack in distal end gut. S. Circular incision of middle layer in-tussusceptum. 5. Forceps on vessels. 6, 7. Ileum divided between clamps. 8. Completion of primaryincision. (Coffey, Annals of Surgery.) d/sT/iL e//i> or luuM \ 3 10 11 fW/ff/iAr/Mien fttinr iu/t/fieo \ fnuiiat iw MfiSMotii pnO/IH/IL CND OF /L£U/f. f{ C. Corrcr Fig. 608. 9. Partial suture distal and ileum. 10. Mesentery ligated. 11. Division of mesentery. 12. Proximalgut closed. (Coffey, Annals of Surgery.) INTUSSUSCEPTION 449 to it. It will probably be better to close the gut entirely and make a lateralanastomosis.) Ligate the mesentery (Fig. 608). Divide the mesentery andremove the gangrenous gut (Fig. 608). Close the proximal end of the ileum(Fig. 608). Make an anastomosis between the and distal segmentsof ileum. K. Israel impressed by the dangers of soiling the peritoneum during exci-sion first delivers the intussuscipiens, sutures its serous coat to the parietalperitoneum, then opens it and excises the intussusceptum as above. He advisesthis method in all types of intestinal stricture producing a temporary artificialintussusception as in Maunsells operation. 3. Ellsworth Eliot, Jr., suggests that the aflfected portion of gut be broughtnear the abdominal wound; a small incision (0) (Fig. 609) be made near theend of
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