. Operative gynecology. tijStal complications. are finally cast off into tlie bowel. The figures sliow also the method of ligat-ing the mesenteric vessels taken from life. The intestine should then be divided with scissors as close to the presectionsutures as possible; two of the sutures are then tied, and the collajDsed rubbercylinder pushed into the bowel with forceps, so that one half lies in each endand the inflation tube comes out in tlie middle. In Fig. 581 the three j^resection sutures are shown tied, and a supplementaryfourth stitch (5) is introduced ; this is cut later to facihtate th
. Operative gynecology. tijStal complications. are finally cast off into tlie bowel. The figures sliow also the method of ligat-ing the mesenteric vessels taken from life. The intestine should then be divided with scissors as close to the presectionsutures as possible; two of the sutures are then tied, and the collajDsed rubbercylinder pushed into the bowel with forceps, so that one half lies in each endand the inflation tube comes out in tlie middle. In Fig. 581 the three j^resection sutures are shown tied, and a supplementaryfourth stitch (5) is introduced ; this is cut later to facihtate the withdrawal ofthe bag. The bag is now inflated with air until the intestine is distended to its normalcaliber. The mesenteric stitch («) (see Figs. 581 to 684) is the first and most importantof the mattress or permanent sutures; by it the submucosa is picked up fourtimes (as indeed by all the mattress stitches), and the mesentery is perforatedtwice; by placing the stitch as shown m the figures the mesenteric border is. •?l^ r^ Fig. 578.—Cikoulak Suture of the Intestine. Showing the lirst step in the introduction of the presection sutures, six in number. These serve, whenthe bowel is resected, to baste the ends together, as it were, facilitating the subsequent application of the mat-tress sutures which secure accurate union throughout. The area to be excised is included within the dottedlines; this must always be carefully selected with reference to the arrangement of the blood vessels, so as tosecure vessels going to the cut edges, and at the same time to avoid including any vessels in the subsequentsuturing, as shown in the figure. Note the ligatures applied to vessels before dividing the intestine. ..; 1 7 M ^ /?/^ ^ I !,_ .w^ ;f5i ?^.^^ *i* ^ ^ jt- . , j:/ Mk-7^r< Fig. 580.—The Introduction of the Collapsel Kubbek Cylinder between the Pkesection Sutures.
Size: 2152px × 1161px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectgenitaldiseasesfemal
