. Annals of surgery. STOMOSIS. Fig. 3 shows two loops of intestine placed side by side,with the first suture tied within one lumen, leaving the twoneedles ready for use. The one on the left is employed to SUTURING HOLLOW VISCERA. 525 make an ordinary running Connell suture to the left of thefirst knot. This is continued only until the corner is turned,when this needle is dropped and the same manoeuvre carriedout with its mate to the right of the first knot. The advantageof beginning in the middle to make this suture is that boththe difficult corners can be turned with the whole wound wideopen,
. Annals of surgery. STOMOSIS. Fig. 3 shows two loops of intestine placed side by side,with the first suture tied within one lumen, leaving the twoneedles ready for use. The one on the left is employed to SUTURING HOLLOW VISCERA. 525 make an ordinary running Connell suture to the left of thefirst knot. This is continued only until the corner is turned,when this needle is dropped and the same manoeuvre carriedout with its mate to the right of the first knot. The advantageof beginning in the middle to make this suture is that boththe difficult corners can be turned with the whole wound wideopen, which is not the case if the operator begins at either that the posterior row has been completed and drawntight, the operator has nothing left to do but continue theanterior row, inserting the stitches in the manner shown bythe needle next the operator in Fig. 2. Each thread makeshalf of this anterior row, the two meeting at the middle of thewound, where they are tied as shown in Fig. 4, and a simple Fig. Lateral anastomosis, first stage. anastomosis thus concluded. Again a Lembert suture maybe superimposed if desired, although I must state that I havefrequently forgotten it and the results have been just the sameas where it was used. END-TO-SIDE ANASTOMOSIS. This somewhat less common form of operation is depictedin Fig. 5, where a Roux gastro-enterostomy is in contempla-tion. Again we have emphasized the importance of the firstsilk loop which approximates the middle of the stomach woundwith that portion of the small intestine which embraces themesenteric insertion. It is scarcely necessary to dwell uponthe further steps of the operation, since they are merely acombination of those given in end-to-end and lateral anas- C26 WILLARD BARTLETT. tomoses. The posterior row approximates the two viscera,being inserted after the continuous Connell method, while theanterior row is again made after the manner of using theneedle next the reader in Fig. 2. The resulting ends of
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
