. Manual of operative surgery. into the lumen of the gut by apurse-string suture as in uncut the suture attached to the uppersegment of gut; apply a hemostat to the endof the suture; the suture will act as a guideto the gut later. Step 3.—Pull the end of the lower segment of gut up into the wound. Oneach side of the gut make a cut through the peritoneum of the meson parallelto the gut and strip back the peritoneum. If the lower part of the sigmoidforms a part of the lower or rectal segment of gut, ligate its vessels which areeasily seen. Continue the incisions in the meson d
. Manual of operative surgery. into the lumen of the gut by apurse-string suture as in uncut the suture attached to the uppersegment of gut; apply a hemostat to the endof the suture; the suture will act as a guideto the gut later. Step 3.—Pull the end of the lower segment of gut up into the wound. Oneach side of the gut make a cut through the peritoneum of the meson parallelto the gut and strip back the peritoneum. If the lower part of the sigmoidforms a part of the lower or rectal segment of gut, ligate its vessels which areeasily seen. Continue the incisions in the meson downwards on each side of therectum, stripping the peritoneum off the meso-rectum. Divide the peritoneumanteriorly so as to separate the rectum from the uterus, or from the bladder,prostate, etc. * This incision is best made in exactly the same way as in McBurneys muscle-splittingoperation of appendectomy. t The above description has been taken, practically completely, from Monod and Van-verts Traite de Technique Fig . 650.—Quenus operation.{Monod and Vanverts.) 5o6 THK kkchm Step 4.—Find and ligate the inferior mesenteric artery just to the left of thepromontory of the sacrum. With gauze wipe downwards all the fat and lym-phatic tissue posterior to the rectum; this is rendered possible by the incision andreflection of the peritoneal surfaces of the meson. While wiping the fat down-wards expose and ligate the middle sacral artery as high as possible. Continue
Size: 1358px × 1839px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
