Operative surgery, for students and practitioners . Fig. 173.—Gastrostomy (Ssabnnajeic-FrruKk). Apex of process of stomachdrawn through the second incision ready for suture. Sutures have been intro-duced for the purpose of closing the first incision. 378 ABDOMEN AND BACK. are exposed and the fibers separated bluntly with the handle of theknife; the fleshy fibers of the transversalis are exposed and split in thesame manner in a transverse direction corresponding to their no muscle fibers are cut. The edges of the incision are drawnapart with blunt retractors and the fascia transvers
Operative surgery, for students and practitioners . Fig. 173.—Gastrostomy (Ssabnnajeic-FrruKk). Apex of process of stomachdrawn through the second incision ready for suture. Sutures have been intro-duced for the purpose of closing the first incision. 378 ABDOMEN AND BACK. are exposed and the fibers separated bluntly with the handle of theknife; the fleshy fibers of the transversalis are exposed and split in thesame manner in a transverse direction corresponding to their no muscle fibers are cut. The edges of the incision are drawnapart with blunt retractors and the fascia transversalis and peritoneumincised. The peritoneal layer is picked up with two toothed forcepsand carefully incised and the anterior wall of the stomach seized anddrawn out through the incision. A IsTo. 25 F. soft-rubber catheter is placed upon the surface ofthe stomach so that it is directed obliquely downward and toward the. Fig. 174. — Gastrostomy (Wit- Fig. 175. — Gastrostomy (Wit- sel). Sutures that infold tlie tube ,zeU. The first row of sutures have in the wall of the stomach have been tied and the tube thus buried been introduced. The end of the between the folds of the stomach tube projects into the stomach wall which have been raised up through a small incision in the about it. A second row of con- wall of the stomach. tinuous sutures have been applied. Two suspension sutures, A and B,have been introduced, one aboveand the other below the pointwhere the end of the tube emerges. right, and in this position it is fixed with four or five interruptedchromic catgut sutures which pick up the wall of the stomach on eitherside of the catheter/each taking a good, broad bite, but not penetratingthrough the entire thickness of the wall of the stomach. In this waythe stomach wall is raised in a fold, or plait, upon each side of thetube so that when the sutures are tied the two folds meet and com-pletely b
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
