. Abdominal hernia : its diagnosis and treatment. Oineiuum spread out before ligatiiig 10 isolate vessles and prevent risk of injuring intestine. sac in fig. 142, pass a ligature around it and cut it off. Workof this type was followed by fatal accidents from secondaryhaemorrhage, and in more than one instance, from injury tobowel that was lying unseen within the omentum. Many years since I advocated a method of ligation thathas become almost universally used by careful surgeons. It 264 ABDOMINAL HERNIA. consists ill drawing down tlie protruding mass until normalomentum is brought outside of th
. Abdominal hernia : its diagnosis and treatment. Oineiuum spread out before ligatiiig 10 isolate vessles and prevent risk of injuring intestine. sac in fig. 142, pass a ligature around it and cut it off. Workof this type was followed by fatal accidents from secondaryhaemorrhage, and in more than one instance, from injury tobowel that was lying unseen within the omentum. Many years since I advocated a method of ligation thathas become almost universally used by careful surgeons. It 264 ABDOMINAL HERNIA. consists ill drawing down tlie protruding mass until normalomentum is brought outside of the canal, being careful not tomake undue traction. It is then spread out by the hands (fig. Fig. Mass of omentum irreducible from quantity and shape. Narrow part at top was in the canal. 143) so that every blood vessel of any considerable size canbe easily seen. Ligation then begins at one side of this slieetof omentum and progresses carefully across to the other. Fat COMPLICATIONS IN SURGICAL CURE. 265 with very small vessels is tied in fairly good quantity, but eachlarge vessel is carefully cleared of its surrounding fat and tiedoff separately. No. 2 chromic catgut has been most frequentlyused as suture material. .\s many as 25 ligatures have beenapplied in removing a piece of omentum. After the ligaturesare in place and the omentum is cut away, the stump, whichis usually left about half an inch long beyond the ligature, isexamined for any bleeding points, and these are also carefullytied. Fig. 145.
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