. Annals of surgery . e feeling that, even if there is no ol)vious inguinal hernia, thisoperation, which I believe to be the best for the closure of the femoral canal,leaves a rather weak internal inguinal ring and a predisposition to the develop- DkWITT stetten ment of inguinal hernia. Therefore, in every case, with or without anactually developed inguinal hernia, I proceed with a typical inguinal hernio-plasty in the manner described above, except that the sutures in the medialhalf of the first, or Bassini suture line, instead of entering at or near theedge of the internal oblique muscle and
. Annals of surgery . e feeling that, even if there is no ol)vious inguinal hernia, thisoperation, which I believe to be the best for the closure of the femoral canal,leaves a rather weak internal inguinal ring and a predisposition to the develop- DkWITT stetten ment of inguinal hernia. Therefore, in every case, with or without anactually developed inguinal hernia, I proceed with a typical inguinal hernio-plasty in the manner described above, except that the sutures in the medialhalf of the first, or Bassini suture line, instead of entering at or near theedge of the internal oblique muscle and conjoined tendon, which has been usedfor the Lotheissen suture, catches the muscle and tendon about one cm. abovethe edge and is tied over the Lotheissen suture line (Figs. lo and ii). Thiscan usually be easily done without the slightest tension. After the inguinalhernioplasty is completed, if possible, a few extra, interrupted Xo. 2 chromiccatgut sutures are placed between Pouparts and the pectineal fascia as in the. Fig. 10.—Sutures of conjoined tendon to Coopers ligament have been tied and inter-rupted sutures of internal oblique muscle and conjoined tendon to Pouparts ligament havebeen inserted from medial angle to exit of cord as in typical inguinal hernioplasty, exceptthat medial sutures grasp muscle and tendon somewhat above edge. Bassini femoral hernia operatiun, to further insure the closure of the femoralcanal (Fig. 11). Very few changes in the after-treatment have lieen adopted. The bowelsare left alone for three or four days, sometimes longer. I do not believethat gas pains are relieved by enemata or colon irrigations. I feel that it isbetter to handle the tissues gently during the operation and then to leave theparetic intestine alone and permit it to recover its tone without , straining at stool twenty-four or forty-eight hours after the hernio-plasty cannot possibly be beneficial to the suture line. A modified Gatch bedis now used to relax
Size: 1741px × 1436px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
