. Diseases of the rectum and anus: designed for students and practitioners of medicine. eads Operation, as describedby the originator, is as follows:— With a case of mixed hemorrhoids involving the entire 454 DISEASES OF THE RECTUM AND ANUS circumference of the anal orifice: if there are only one or twosingle hemorrhoids, then each can be dealt with separately ina similar manner, except that the forceps can then be appliedparallel with the long axis of the rectum; the skin is caughtat each quadrant of the anal orifice, just at the white line ofHilton, with hemostatic forceps, and with them the
. Diseases of the rectum and anus: designed for students and practitioners of medicine. eads Operation, as describedby the originator, is as follows:— With a case of mixed hemorrhoids involving the entire 454 DISEASES OF THE RECTUM AND ANUS circumference of the anal orifice: if there are only one or twosingle hemorrhoids, then each can be dealt with separately ina similar manner, except that the forceps can then be appliedparallel with the long axis of the rectum; the skin is caughtat each quadrant of the anal orifice, just at the white line ofHilton, with hemostatic forceps, and with them the skin andmucous membrane is pulled down; this brings into view anyinternal hemorrhoids that may exist, when they also arecaught with hemostats and drawn well down. An incision isthen made at the center of the anal orifice posteriorly, suffi-ciently deep to allow Earles clamp-forceps (Fig. 153) to beapplied at right angles to the long axis of the rectum, andat the same time to include in the forceps the amount of tissueto be removed in this part of the zone, care being taken to in-. Fig. 153.—Earles Clamp-forceps. elude in the forceps more of the mucous membrane than theskin. Before applying the forceps, the first two stitches todraw together the skin and mucous membrane should be takenat the bottom of the incision. With the forceps now appliedand held in position the tissue above the forceps is cut away,and a running suture is begun by passing it first under, andthen over the forceps, until the end of the forceps is reached,when they are withdrawn, and the suture is drawn taut. An-other similar bite of the redundant tissues is taken in the samemanner with the forceps, cut ofif, sutured, and so on, until theentire redundant tissue is removed, including all piles fromthe orifice, and the cut edges of the skin and mucous mem-brane are nicely apposed by the running suture, the skin beingturned in, which is accomplished by sewing from within out-ward. All hemorrhage is controlle
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanusdis, bookyear1910
