Operative surgery, for students and practitioners . the stomach, low down, parallel withand close to the line of suture that closes the end of the stomach—within two inches. This is accomplished with a continuous non-pene-trating suture of silk. After the posterior half of the circumference ofthe stump of the duodenum has been sutured to the wall of the stomach,the clamp is removed from the end of the duodenum and the needle,still carrying the thread which was used to sew the duodenum to thestomach, is temporarily laid aside. Before the clamp is removed fromthe end of the duodenum a strip of n
Operative surgery, for students and practitioners . the stomach, low down, parallel withand close to the line of suture that closes the end of the stomach—within two inches. This is accomplished with a continuous non-pene-trating suture of silk. After the posterior half of the circumference ofthe stump of the duodenum has been sutured to the wall of the stomach,the clamp is removed from the end of the duodenum and the needle,still carrying the thread which was used to sew the duodenum to thestomach, is temporarily laid aside. Before the clamp is removed fromthe end of the duodenum a strip of narrow tape is passed around theduodenum or a compressor clamp with rubber-sheathed blades is 392 ABDOMEN AND BACK. applied so as to prevent the escape of contents from the duodenumwhen the clamp is removed. The stomach is incised just in front ofand parallel with the line of suture that joins the end of the duodenumto it. Hemorrhage from the incision in the stomach is controlled byclamping and ligating bleeding points. With a through-and-through. Fig. 180.—Pylorectomy (Eocher). Stump of the duodenum has been joinedto the posterior wall of the stomaeh by a row of continuous Lembert has been made in the stomach to receive the end of the duodenum. chromic catgut suture the edge of the duodenum is united to the edgeof the incision on the stomach all around. This suture includes allthe coats, especial care to include the edges of the mucous the end of the duodenum has thus been sutured to the openingin the stomach all around the needle, carrying the silk thread withwhich the posterior half of the non-penetrating suture that joins theduodenum to the stomach was introduced, is again taken in hand and OPERATIONS UPON THE STOMACH. 393 the anastomosis completed by introducing the anterior half of theoutside, non-penetrating ring suture. Hartmanns Method of Gasteectomy.—The partial gastrec-tomy, according to the method of Hartmann, is performed forcanc
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