Operative surgery, for students and practitioners . nds of this ligature areleft long to serve as a temporary tractor. The appendix is seizedwith an artery clamp upon the distal side of the ligature to preventleakage when it is cut, and with a straight scissors it is amputatedbetween the clamp and ligature. While the stump of the appendixis steadied by making traction with the ligature which was leftlong intentionally for that purpose, the raw end of the stump is OPERATIONS UPON THE VERMIFORM APPENDIX. 481 touched with pure carbolic acid on a small probe or else it is cau-terized with a pointe
Operative surgery, for students and practitioners . nds of this ligature areleft long to serve as a temporary tractor. The appendix is seizedwith an artery clamp upon the distal side of the ligature to preventleakage when it is cut, and with a straight scissors it is amputatedbetween the clamp and ligature. While the stump of the appendixis steadied by making traction with the ligature which was leftlong intentionally for that purpose, the raw end of the stump is OPERATIONS UPON THE VERMIFORM APPENDIX. 481 touched with pure carbolic acid on a small probe or else it is cau-terized with a pointed Paquelin. The ligature is cut short and thestump of the appendix allowed to drop back into the is a safe way of dealing with the appendix stump and is espe-cially satisfactory in cases where unusual difficulty would be experi-enced in inverting it, etc. 2. Inversion of the Stump or the Appendix with Purse-string (Dawbarn).—After the mesentery has been ligated and cutfree from the appendix, the latter is steadied and a purse-string. Fig. 226.—Appendicectomy. Mesoappendix has been ligated and a purse-string suture has been introduced around the root of the appendix, and theorgan amputated. The stump is seized with a forceps preliminary to invert-ing it into the c£ecum. suture of No. 1 chromic catgut introduced in the wall of the caecumso as to surround the root of the appendix at a distance of aboutone-fourth inch all around. This suture should include only theserous and muscular coats of the c<ficum; yet, even at the risk ofpenetrating into the lumen of the bowel, it should take a good,secure bite with each stitch. The purse-string suture is not drawntight nor tied, but the first loop of a surgeons knot is taken. Then,without applying any ligature around its root the appendix is seizedwith an artery forceps and cut away with the scissors, leaving astump about one-quarter inch long. The stump does not cut end of the stump is seized with a thumb fo
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