. Modern surgery, general and operative. us, however, the amount of pressure obtained isalways uncertain and the rub-ber is apt to wear out. Thebutton gives a lower mortalitythan the suture operation, andsome surgeons now use it whoonce condemned it. Czemy isa strong advocate of thebutton. Harrington and Gould usea segmented aluminum ring collapses into smallsegments after the anastomosishas been effected. By its usethe authors believe that theoperation is made more rapidlyand safely (Annals of Sur-gery, Nov., 1904). Duringthe suturing the ring is held bymeans of a handle, which, aft
. Modern surgery, general and operative. us, however, the amount of pressure obtained isalways uncertain and the rub-ber is apt to wear out. Thebutton gives a lower mortalitythan the suture operation, andsome surgeons now use it whoonce condemned it. Czemy isa strong advocate of thebutton. Harrington and Gould usea segmented aluminum ring collapses into smallsegments after the anastomosishas been effected. By its usethe authors believe that theoperation is made more rapidlyand safely (Annals of Sur-gery, Nov., 1904). Duringthe suturing the ring is held bymeans of a handle, which, afterthe anastomosis has beeneffected, is removed. Thering in the handle is shown inFig. 778 and the operation inFigs. 779 and 780. ^Maunsell has devised amost ingenious method of cir-cular enterorrhaphy. The twoportions of bowel are attachedby two fixation sutures whichpenetrate all the coats (Fig. 781). An incision iH inches in length is made through the wall of theproximal segment of gut, about i inch from its edge. The fixation sutures. Fig. -Maunsells method of anastomosisWiggin). (after I2^0 Diseases and Injuries of the Abdomen are brought through this opening, traction is made upon them, the distalportion of the bowel is invaginated into the proximal portion, and the endsemerge from the opening, their peritoneal surface being in contact (Fig. 781).Sutures of silk are passed through both sides of the area of invagination, thethreads are caught up in the center, cut, and tied on each side. The fixationsutures are cut off. The invagination is reduced by traction. The longitudinalcut is closed bv Lembert sutures.
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Keywords: ., bookcentury1900, bookdecade1910, bookidmodernsurger, bookyear1919
