Operative surgery . d the organat the borders of the abdominal wound should be practiced to obviate peri-toneal infection. Forcible manipulations in the extraction of foreign bodies,or in extended digital exploration of the stomach or the oesophagus carriedon through inadequate incisions, are often needlessly prolonged and are harm-ful. When the size and mobility of the stomach will permit it should beextensively drawn through the abdominal opening before being incised orexplored (Fig. 767). Transverse openings into the stomach cause less haem-orrhage than longitudinal ones; but extensive long
Operative surgery . d the organat the borders of the abdominal wound should be practiced to obviate peri-toneal infection. Forcible manipulations in the extraction of foreign bodies,or in extended digital exploration of the stomach or the oesophagus carriedon through inadequate incisions, are often needlessly prolonged and are harm-ful. When the size and mobility of the stomach will permit it should beextensively drawn through the abdominal opening before being incised orexplored (Fig. 767). Transverse openings into the stomach cause less haem-orrhage than longitudinal ones; but extensive longitudinal incisions mademidway between the greater and lesser curvatures do not, for anatomical 600 OPERATIVE SURGERY. reasons, cause dangerous hasmorrhage. In digital and instrumental explora-tions the gastric incisions are made comparatively small and located so asto shorten the route to the objective point. In digital exploration of thestomach it is difficult indeed sometimes to locate with the fingers the site of. Fig. 767.—Delivery of stomach and introduction of forceps. the oesophageal opening, because of its obliteration due to contraction of thewalls of the stomach, provoked no doubt by the presence of the , if the finger be pressed cautiously for a time at the site of theopening relaxation will take place and the end of the finger will readilyenter the tube. Downward traction on the stomach attended with flexionof the cervical and portions of the spine render the cardiac openingmore accessible to manipulation. The putting of the lesser curvature onthe stretch by downward traction on the stomach enables one to readily passa bougie along the curvature into the cardiac oi^ening, if the gastricincision be located well to the right. Stricture of the (Esophagus.—For the jourpose of consideration, stric-ture of the oesophagus will be classified as malignant and non-malignant, andalthough either may be treated by dilatafion, divulsion, exte
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