. Diseases of the rectum and anus: designed for students and practitioners of medicine. produced a nar-rowing of both. Gants Posterior Proctoplasty.—In cases of moderate pro-lapse the author has on three occasions accomplished a cureby attacking the bowel from behind and shortening it severalinches. The steps of this operation are as follows:— 396 DISEASES OF THE RECTUM AND ANUS With the patient in the exaggerated Sims position, underaseptic conditions an incision, one and a half inches ( centi-meters) in length, is made just below and transverse to thecoccyx and carried down to the rectum,
. Diseases of the rectum and anus: designed for students and practitioners of medicine. produced a nar-rowing of both. Gants Posterior Proctoplasty.—In cases of moderate pro-lapse the author has on three occasions accomplished a cureby attacking the bowel from behind and shortening it severalinches. The steps of this operation are as follows:— 396 DISEASES OF THE RECTUM AND ANUS With the patient in the exaggerated Sims position, underaseptic conditions an incision, one and a half inches ( centi-meters) in length, is made just below and transverse to thecoccyx and carried down to the rectum, which is freed from itsposterior attachments. The sphincter is then divulsed, and,with the index and middle fingers passed full length into therectum, the bowel is pushed out through the opening andpulled down as far as possible (Fig. 129). A longitudinal incision, from two to four inches (5 to 10centimeters) in length, is now made through the rectal coats^(Fig. 129), and the bowel is shortened the length of this in-cision by bringing the angles of the cut together, thus making. Fig. 131.—Gants Operation for Procidentia Recti. Third Step: Showingthe Skin Incision Closed with Interrupted Catgut Sutures After the Bowelhas been Returned. its direction transverse and closing it with the Lembert suturesof fine silk or catgut (Fig. 130). Before inserting the stitchesall hemorrhage must be arrested. The wound is then dustedover with aristol, and the gut returned through the externalincision, which is then closed with catgut (Fig. 131). The rectum should now be irrigated and dried and theintrarectal wound protected from infection by non-absorbablewool, dusted over with iodoform. While no complications occurred in the three cases treatedby posterior proctoplasty, the author nevertheless realizes thedanger of infection, abscess, and fistula from this procedureunless strict asepsis be maintained. In one sucressful case the incision was only carried through the muscular coats. PROLA
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
