. A manual of gynæcology and pelvic surgery, for students and practitioners. end of the loop to be removed. on the ends which are to be joined should be covered with rubbertubing. The intestine, between the pairs of clamps at each end of thedamaged loop, is now cut somewhat obHquely, so that the marginof the intestine opposite the mesentery is not deprived of itsblood supply. The cut ends are sponged clean, the loop to beremoved thoroughly wrapped in a towel, its mesentery clampedand cut between the forceps and gut, and the resected portion INTESTINAL OBSTRUCTION: INTESTINAL RESECTION 625 at o
. A manual of gynæcology and pelvic surgery, for students and practitioners. end of the loop to be removed. on the ends which are to be joined should be covered with rubbertubing. The intestine, between the pairs of clamps at each end of thedamaged loop, is now cut somewhat obHquely, so that the marginof the intestine opposite the mesentery is not deprived of itsblood supply. The cut ends are sponged clean, the loop to beremoved thoroughly wrapped in a towel, its mesentery clampedand cut between the forceps and gut, and the resected portion INTESTINAL OBSTRUCTION: INTESTINAL RESECTION 625 at once disposed of. The mesentery is quickly tied with sutureKgatures and the ends of the intestine brought together andunited with two rows of continuous stitches, an inner haemos-tatic and tension row, and an outer for the approximation ofthe serous surfaces upon which approximation intestinalanastomosis depends for its safety. Suturing is sometimeseasier if the ends of the cut intestine are caught with a temporarystitch on their free margin, thus allowing the sewing to be. Fig. 272.—Intestinal obstruction. Gangrene. Resection. The involvedloop has been severed at each end. The mesentery is being clamped. Notegauze protection of all exposed mucosa. done in halves, but this is not necessary if the clamps areproperly placed. Leakage after intestinal resection is mostlikely to occur at the mesenteric margin of the gut in whichlocahty it is not covered by peritoneum, and this margin shouldreceive special attention. The inner stitch of line chromic catgut penetrates all thecoats of the intestine, and it should begin at one side of thisuncovered area so that it may not be disturbed by knots. At40 626 POST-OPERATIVE COMPLICATIONS AND SEQUELS its beginning this stitch passes from the mucosa of one side,through all the intestinal coats, and emerges on the mucosaof the other side. It is tied and then continued around the cutedges of the bowel until the free margin opposite the mesenter
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