Operative surgery, for students and practitioners . ew stitches. The ends are then tied andcut short. By rolling the bowel between the fingers the knot willbe made to slip into the lumen of the gut. With Murphy Button.—Having resected the gut as abovedescribed, a running string is placed in the edge of each segmentof the gut which, when drawn tight and tied, puckers the end ofthe gut and grasps the button about its shank, leaving the flangeor cup of the button within the gut. This running stitch, or purse-string, is applied in overhand fashion, is of chromic catgut andcarried upon two long, st
Operative surgery, for students and practitioners . ew stitches. The ends are then tied andcut short. By rolling the bowel between the fingers the knot willbe made to slip into the lumen of the gut. With Murphy Button.—Having resected the gut as abovedescribed, a running string is placed in the edge of each segmentof the gut which, when drawn tight and tied, puckers the end ofthe gut and grasps the button about its shank, leaving the flangeor cup of the button within the gut. This running stitch, or purse-string, is applied in overhand fashion, is of chromic catgut andcarried upon two long, straight needles, one at each end. Thisstitch includes all the layers of the gut, especially the serous and 433 ABDOMEN AND BACK. the mucous membrane; it should not include too wide a margin ofthe , since the amount of tissue which is grasped between theflanges, or cups, of the button may be too bulky to allow exactcoaptation; a margin of rather less than one-fourth inch is suffi-cient. The running stitch is commenced by piercing the mesentery. Fig. 201.—End-to-End Anastomosis (Murphy Button). With the purse-stringsuture a loop is taken through the layers of the mesentery, close to the wall ofthe gut, in order to obliterate the dead space. close to the surface of the gut, and then, carrying the same needleback over the edge of the mesentery, it is again thrust through,so that we thus have a loop around the cut edge of the mesenteryclose to the surface of the gut. With this same needle the runningsuture is applied to the corresponding half of the circumferenceof the cut edge of the gut; each puncture of the needle should bemade from within the lumen of the gut, from its mucous-membraneaspect, and the punctures should be about one-third inch apart. OPERATIONS UPON THE SMALL INTESTINE. 433 When a point is reached directly opposite the mesenteric border ofthe gut, this needle is discarded; the second needle is then takenin hand and the second half of the circumference of the
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Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
