. Manual of operative surgery. rushing one likePayrs; for the proximal segment of gut any efficient clamp, such as Ochsners,will serve. Cut between the clamps with a cautery and burn the stumpsprotruding from the clamps even to such an extent that the Payrs clamp isheated sufficiently to char the tissues crushed between its jaws. Insert acontinuous fine chromic catgut suture, in the Gushing fashion, the bites beingalternately on each side of the clamp and the threads crossing it (Fig. 533). Remove the Payrs clamp, pulling its blades out from under the divided duodenum is so crushed
. Manual of operative surgery. rushing one likePayrs; for the proximal segment of gut any efficient clamp, such as Ochsners,will serve. Cut between the clamps with a cautery and burn the stumpsprotruding from the clamps even to such an extent that the Payrs clamp isheated sufficiently to char the tissues crushed between its jaws. Insert acontinuous fine chromic catgut suture, in the Gushing fashion, the bites beingalternately on each side of the clamp and the threads crossing it (Fig. 533). Remove the Payrs clamp, pulling its blades out from under the divided duodenum is so crushed and charred that it remains closed. Pull PYLORECTOMY 399 on the ends of the suture. As tension is put on the suture the wound becomesinverted as by a continuous Lembert suture. Fasten the ends of the in an extra line of mattress sutures to reinforce the closure. Suture theduodenal stump to the area of pancreas denuded during the mobilization ofthe duodenum or to the edge of the fascia which covered the pancreas. Fif 535-— Thierry de Mattels Clamp. Thierry de Martel (La Pr. Med., July 7, 1910) uses a powerful clamp whichcrushes evenly. Figs. 535 and 536 sufficiently explain it. Two of the clampsare applied to the duodenum and two to the stomach, section of the viscerabeing made between each pair of instruments; de Martel applies an ordinaryintestinal clamp to the intestine before removing the crushing clamp and closesthe viscus with two lavers of suture.*
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Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
