. American practice of surgery ; a complete system of the science and art of surgery . ificial anus. Without an adequate circulation sloughing, gan-grene, and death are almost sure to occur. SURGICAL DISEASES OF THE ANUS AND RECTUM. 919 (f) \aginal Method.—Extiri):ili(jii of [hv ructuiu by way of t\ vagina hasbeen practised since 1890, when it \\as introduced by Desguins, and it hasproved a most successful operation, so fai-, at least, as mortality is it was employed only in the case of tumors located within the firsttwo or three inches of the rectum; but, more recently, sin
. American practice of surgery ; a complete system of the science and art of surgery . ificial anus. Without an adequate circulation sloughing, gan-grene, and death are almost sure to occur. SURGICAL DISEASES OF THE ANUS AND RECTUM. 919 (f) \aginal Method.—Extiri):ili(jii of [hv ructuiu by way of t\ vagina hasbeen practised since 1890, when it \\as introduced by Desguins, and it hasproved a most successful operation, so fai-, at least, as mortality is it was employed only in the case of tumors located within the firsttwo or three inches of the rectum; but, more recently, since these tumors havebeen so easily managed throuiih the perineum, the va,t2;inal operation is appliedonly to tumors located high up in the rectum and in the; sigmoid. Murphy, ofChicago, was the first to give the details of this operation as it is now (withsome variation) employed. His method (Figs. 384 to 388) is as follows:The patient is placed in the extreme lithotomy position, -\\ith the hi{)s slightlyelevated. The vagina is dilated with broad retractors, the cervix is drawn. Fig. 382.—Final Step in Bone-flap Operation. G, Gauze draining sacral ca\ity; T, Lynch tube inanus. (Tuttle: Diseases of the Anus, Rectum, and Pelvic Colon, P. Appleton & Co., New York.) down, and Douglas cul-de-sac is opened by a transverse incision just belowthe line of juncture with the cervix uteri. The contents of the cul-de-sac aredisplaced upward by the introduction of abdominal pads. A vertical incisionis next made, in the median line, through the recto-vaginal septiun down to thewall of the bowel, and including the external sphincter. (Fig. 38-1.) The flapsare then dissected, one from each side of the rectum, the peritoneal supports ofthe rectum being cut as high up as the meso-rectum on both sides. (Fig. 385.)The rectum is thus exposed in its entire length anteriorly and on the sides,which enables one to bring down the sigmoid flexure to its full extent. Murphythen divides the anterior rec
Size: 1790px × 1396px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
