. A manual of operative surgery . ncy for the open-ing to contract (thishas been repeatedly ob-served with the button),and many surgeons,after a trial of theother method, have re-turned to simple sutur-ing. The rapidity withwhich the latter can beperformed largely de-pends on practice t, the use of the con- C, Clamp holding loop of J, the jejunum, which is then completely divided into proximal (b) and distal portion tinUOUS SUture instead(a). For completion of operation see next figure. of interrupted some of the earlier cases it is recorded that two, three, oreven more hou
. A manual of operative surgery . ncy for the open-ing to contract (thishas been repeatedly ob-served with the button),and many surgeons,after a trial of theother method, have re-turned to simple sutur-ing. The rapidity withwhich the latter can beperformed largely de-pends on practice t, the use of the con- C, Clamp holding loop of J, the jejunum, which is then completely divided into proximal (b) and distal portion tinUOUS SUture instead(a). For completion of operation see next figure. of interrupted some of the earlier cases it is recorded that two, three, oreven more hours were taken. A surgeon with experience of theoperation need rarely spend an hour over the operation fromthe first step to the last. Many elaborate modifications have been practised with theview of preventing regurgitation from the intestine into thestomach. Of these the Y method of Roux, illustrated by and 64, may be taken as an example. It involves completedivision of a loop of jejunum, implantation of one end into the. FIG. 63.—ROUXS Y METHOD OF GASTROJEJUNOSTOMY. CHAP. Ill] GASTRO-J E J UNOSTOM Y 215 stomach and of the other into the side of the jejunum. Somesurgeons bring up a loop of jejunum, make the communicationbetween it and the stomach, and in addition a lateral anasto-mosis between the two sides of the loop (afferent and efferentportions). We believe that the simplest method gives the bestresult, and the fear of a vicious circle being established is ground-
Size: 1543px × 1619px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
