Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ing occurs it should be stoppedby interrupted sutures. THE ABDOMEN 769 The extra suture, applied at either end of the anastomosis to preventkinking and relieve the suture line of tension is important. It is neithernecessarv nor wise to make a loop or half turn in the bowel at the anasto-mosis. It should lie in its natural position (Fig. 1441). The jejunum passesfrom right to left, and in this position it should be connected to the stomach(Fig. 1442). For the inner
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ing occurs it should be stoppedby interrupted sutures. THE ABDOMEN 769 The extra suture, applied at either end of the anastomosis to preventkinking and relieve the suture line of tension is important. It is neithernecessarv nor wise to make a loop or half turn in the bowel at the anasto-mosis. It should lie in its natural position (Fig. 1441). The jejunum passesfrom right to left, and in this position it should be connected to the stomach(Fig. 1442). For the inner suture catgut is preferable because nonabsorbable suturemay hang into the lumen of the. bowel for a long time. The through-and-through mattress suture (Conneil) is used by some. For the seromuscularsuture celluloid linen (Pagenstecher), paraffined linen, or silk is to be preferred,although many surgeons use chromicized catgut. Posterior anastomosis with the Murphy button may be done by the sametechnic as described for entero-anastomosis. It has been quite supersededby the suture method. Stomach . TransverseColon. .. .Jejunum Fig. 1442.—Posterior median section of abdomen showing stomach and intestines. Diagram W. J. Mayo called attention to the band which connects the jejunum tomesocolon, and sometimes turns it to the right. This band when prominentrequires to be divided (Fig. 1443). Anterior gastrojejunostomy is done when the posterior operation cannotbe performed because of the presence of adhesions or abnormally shortmesocolon. It is also to be preferred in obstructive cancer of the pyloruswhich cannot be removed. The operation is done speedily and safely; butfor permanent drainage of the stomach it does not serve so well as the pos-terior operation. The abdomen is opened through the sheath of the rightrectus muscle, and the stomach and transverse colon turned up as for pos-terior gastro-enterostomy. The beginning of the jejunum is id
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
