. Manual of operative surgery. ton with hemostatic forceps and introduceits head into the gut. Weir has found thatthe forceps may so injure the button as torender it unsafe. Dawbarn plugs the twosegments of the button with corks, thus pro-viding handles and at the same time preventing escape of intestinal has devised ingenious metal handles to plug the button and takethe place of the corks. Pull the purse-string tight and tie it in such a manner that the openingin the gut is snugly fastened around the neck of the button (Fig. 555). Withscissors or knife remove any excess of ti
. Manual of operative surgery. ton with hemostatic forceps and introduceits head into the gut. Weir has found thatthe forceps may so injure the button as torender it unsafe. Dawbarn plugs the twosegments of the button with corks, thus pro-viding handles and at the same time preventing escape of intestinal has devised ingenious metal handles to plug the button and takethe place of the corks. Pull the purse-string tight and tie it in such a manner that the openingin the gut is snugly fastened around the neck of the button (Fig. 555). Withscissors or knife remove any excess of tissue distal to the suture which mightinterfere with the proper approximation of the two halves of the Steps 2 and 3 on the other loop of gut. Step 4.—Remove the hemostatic forceps or corks from the two halves ofthe button. Insert the neck of the male half of the button into that of thefemale half and push them together firmly (Figs. 556 and 557). A few pointsof Lembert suture may be used to reinforce the Fig. 553.—Lateral anastomosis. Clamps in place. Posterior row seroussutures in place. Gut incised; through-and-through or Connell suture the through-and-through suture isin place completely around the anastomoticopening, remove the clamps and theninsert the anterior row of serous this diagram it is assumed that a por-tion of gut has been excised; that bothafferent and efferent loops have been S. indicates the line of union of themesentery of the two loops of the gut. Noholes must be left in the mesentery. 4i6 OPERATIONS ON THE INTESTINES In Step 2 the incision may be made into the gut before the purse-stringsuture is introduced. A good method of applying the stitch is shown in Fig. 558.
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