Operative surgery, for students and practitioners . com-pletely with a line of suture which is applied before the forceps isremoved. This is a througli-and-through suture of chromic catgutand is applied close to the blades (upon their proximal side). Atevery fourth or fifth puncture of the needle a ^TDack-stitch shouldbe made in order to prevent the suture from drawing and producingthe puckering-string effect. This line of suture serves to closethe opening in the stomach and at the same time controls thehemorrhage. After the suture has been introduced the forceps isremoved. If the edge of the
Operative surgery, for students and practitioners . com-pletely with a line of suture which is applied before the forceps isremoved. This is a througli-and-through suture of chromic catgutand is applied close to the blades (upon their proximal side). Atevery fourth or fifth puncture of the needle a ^TDack-stitch shouldbe made in order to prevent the suture from drawing and producingthe puckering-string effect. This line of suture serves to closethe opening in the stomach and at the same time controls thehemorrhage. After the suture has been introduced the forceps isremoved. If the edge of the stomach beyond the line of the sutureis too broad it may be trimmed off with the scissors. A continuousLembert suture of silk is then applied. This row of Lembert suturetakes a good, broad bite in the wall of the stomach at each punc-ture, and inverts the edges and completely buries the first through-and-through catgut suture. After the end of the stomach has been thus closed we areready for the final step of the operation, the restoration of the. Fig. 1S4.—Gastrectomy (Mayo). The great and lesser omenta have been tiedoff and divided, and the gastric and pyloric arteries ligated. The hand is passeddown behind the stomach to free it from adhesions, posteriorly. Two clampshave been applied to the duodenum preparatory to dividing it. The blades ofthe distal clamp are sheathed with rubber. 398 ABDOMEN AND BACK. continuity of the alinientai^ canal. This is accomplished eitherby uniting the cut end of the duodenal stump to a new openingwhich is made in the posterior wall of what remains of the stomach,gastro-duodenostomy according to the method of Kocher; or else theend of the stump of the duodenum is closed by suture and a communi-cation established between the stomach and a coil of the jejunum—agastro-jejunostomy. The choice between these two procedures willdepend upon the mobility and length of the stump of the duodenum,the preference being given to the gastro-duodenosto
Size: 1274px × 1961px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
