. A manual of gynæcology and pelvic surgery, for students and practitioners. ion. The involvedloop has been severed at each end. The mesentery is being clamped. Notegauze protection of all exposed mucosa. done in halves, but this is not necessary if the clamps areproperly placed. Leakage after intestinal resection is mostlikely to occur at the mesenteric margin of the gut in whichlocahty it is not covered by peritoneum, and this margin shouldreceive special attention. The inner stitch of line chromic catgut penetrates all thecoats of the intestine, and it should begin at one side of thisuncove
. A manual of gynæcology and pelvic surgery, for students and practitioners. ion. The involvedloop has been severed at each end. The mesentery is being clamped. Notegauze protection of all exposed mucosa. done in halves, but this is not necessary if the clamps areproperly placed. Leakage after intestinal resection is mostlikely to occur at the mesenteric margin of the gut in whichlocahty it is not covered by peritoneum, and this margin shouldreceive special attention. The inner stitch of line chromic catgut penetrates all thecoats of the intestine, and it should begin at one side of thisuncovered area so that it may not be disturbed by knots. At40 626 POST-OPERATIVE COMPLICATIONS AND SEQUELS its beginning this stitch passes from the mucosa of one side,through all the intestinal coats, and emerges on the mucosaof the other side. It is tied and then continued around the cutedges of the bowel until the free margin opposite the mesenteryis reached. It facilitates sewing to tie the stitch at this point,and then reverse the needle in such manner as to penetrate from. Fig. 273.—Intestinal obstruction. Resection. End-to-end anastomosis. Theinner stitch penetrates all the coats of the intestine, and the first knot is at oneside of the portion of gut not covered by peritoneum. the peritoneum of one side through all the coats of both ends andout on the peritoneal surface of the opposite side. In thisfashion the cut edges of that half of the intestine sewn last,show the margin of the mucosa, and, as Moynihan has pointedout, bleeding is readily seen and controlled if the clamps areremoved before the serous stitch is begun. The serous stitchshould start on the mesentery proximal to its attachment to INTESTINAL OBSTRUCTION: INTESTINAL RESECTION 627 the gut, SO that several stitches are passed before the gut itselfis reached. Just below the attached margin of the gut thestitch passes through the mesentery to the opposite layer ofperitoneum. It then crosses the cut edges of the m
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Keywords: ., bookcentury1900, bookdecade1910, bookidman, booksubjectgynecology
