Modern surgery, general and operative . ent (Halsted). The next step is to carry the inferior flap, composed of cremaster muscle andfascia, under the internal oblique muscle, and suture it there (Fig. 743). Wenext suture the internal oblique muscle and the conjoined tendon to Pou-parts ligament, the lower edge of the internal obhque being tucked underthe edge of the ligament (Fig. 744). In order to accomplish this, it maybe necessary to release the muscle by incising the anterior rectal sheath. Theincision in the external oblique is now closed with sutures that overlap themargins (Figs. 745 an
Modern surgery, general and operative . ent (Halsted). The next step is to carry the inferior flap, composed of cremaster muscle andfascia, under the internal oblique muscle, and suture it there (Fig. 743). Wenext suture the internal oblique muscle and the conjoined tendon to Pou-parts ligament, the lower edge of the internal obhque being tucked underthe edge of the ligament (Fig. 744). In order to accomplish this, it maybe necessary to release the muscle by incising the anterior rectal sheath. Theincision in the external oblique is now closed with sutures that overlap themargins (Figs. 745 and 746), and the skin wound is also closed. Halsteds Operation Plus Bloodgoods Method of Transplanting the RectusMuscle.—(See Jos. C. Bloodgood, in Johns Hopkins Hosp. Reports, voL Treatment of Reducible Hernia 1145 vii.) WTien the conjoined tendon is ven- thin or obUterated, the ordinaryoperation is not enough. Insufficiency of the conjoined tendon is known toexist when a linger does not meet any obstruction after passing through the. -tl Fig. 745.—Suture of the aponeurosis of the ex-ternal obhque (^Halsted).
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
