. Operative gynecology. gbecomes much less. The chief objections to the button are that it is a heavy piece of metal, thatit gives at best but a small anastomotic hole liable to extreme contraction, andthat if not made or selected with extreme care the pressure between the opposedsurfaces is sometimes great enough to cause sloughing. Artificial Anus — Colostomy .—When an ineradicable raahgnantdisease of the uterus or of the ovaries chokes the pelvis so as to produce anobliteration of the lumen of the rectum, it will often be found necessary to makean artificial anus to prevent the patient from
. Operative gynecology. gbecomes much less. The chief objections to the button are that it is a heavy piece of metal, thatit gives at best but a small anastomotic hole liable to extreme contraction, andthat if not made or selected with extreme care the pressure between the opposedsurfaces is sometimes great enough to cause sloughing. Artificial Anus — Colostomy .—When an ineradicable raahgnantdisease of the uterus or of the ovaries chokes the pelvis so as to produce anobliteration of the lumen of the rectum, it will often be found necessary to makean artificial anus to prevent the patient from dying from simple obstruction ofthe bowels. By this procedure frightful pain may be relieved immediately, lifeprolonged many months, and euthanasia secured. The best place to make the opening is under the left anterior superior iliacspine over Pouparts ligament; but if the disease involves the upper part of therectum, it will be better to do the operation on the right side and so avoid thenecessity of repeating Fig. 587.—Makoto a Sigmoid Ands iif Occlusion of the Lowek figure shows a vertical section through the wound with two of the sutures uniting the visceral to theparietal pcritoueum. K. 0. March 23,1806. The accompanying illustrations (Figs. 58Y and 588) show how to operate:A funnel-shaped incision 6 to 8 centimeters long is made through skin, fat, mus-cles, and peritoneum, about 3 centimeters above and parallel to Pouparts liga-ment, beginning just below the iliac spine. The sigmoid is usually found justunder the incision and is sutured to the peritoneum and subperitoneal tissue byinterrupted sutures of fine silk placed close together, each one penetrating thefibrous layer of the bowel. The free surface of the bowel, covering an oval ARTIFICIAL ANUS. 517 area about 2x4 centimeters should in this way be made to fill in the bottomof the incision. One of two plans may now be adopted : either the skin margins may beturned in and united to the muscular la
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
