Operative surgery . omenta from the stomach and duo-denum bv means of ligatures and scissors carried as close to the structures as 770 OPERATIVE SURGERY. is consistent with proper removal of the disease (Fig. 985); lift the isolatedtumor still farther into the wound and pack around it hot, dry aseptic gauzeor sponges so completely as to prevent the possibility of infection of theabdominal cavity and exposed peritonaeum ; clamp the duodenum close tothe edge of the tumor and outside of this point (Fig. 986), and also the stom-ach at the cardiac side of the tumor, with one or more forceps or by o
Operative surgery . omenta from the stomach and duo-denum bv means of ligatures and scissors carried as close to the structures as 770 OPERATIVE SURGERY. is consistent with proper removal of the disease (Fig. 985); lift the isolatedtumor still farther into the wound and pack around it hot, dry aseptic gauzeor sponges so completely as to prevent the possibility of infection of theabdominal cavity and exposed peritonaeum ; clamp the duodenum close tothe edge of the tumor and outside of this point (Fig. 986), and also the stom-ach at the cardiac side of the tumor, with one or more forceps or by othersuitable means, after pushing aside the contents. The Remarks.—The diseased portion should be raised well out of theabdominal cavity in order to permit of as complete extra-peritoneal opera-tion as possible. The severance from the stomach of the greater and lesseromenta extends a little beyond the diseased area (Fig. 986, Z», /), and isaccomplished by double ligatures of chromicized gut, or by silk applied to. Fig. 985.—The posterior surface of the stomach, a, a. Gastrocolic omentum, h. Pan-creas beneath transverse mesocolon, c. Spleen, d. Splenic vein. e. Descendingduodenum. /. Papillary tubercle. isolated portions of the omental tissue by means of an aneurism needle orClevelands ligature carrier (Fig. 983, /). The width of the portion graspedby the respective ligatures will be governed by the thickness of the tissueand the size and number of its vessels, remembering to include only theamount that can be securely tied. The illustration (Fig. 986) indicatesapproximately the number and distance between the ligatures. The Resection of Diseased Tissues (Fig. 986).—Sever the duodenum withscissors and thoroughly disinfect the distal end with a strong sublimate solu- OPERATIONS ON VISCKIIA CONNECTED WITH TERITONvEUM. 771 tiou ; wrup the cud in stiiilizid giiuze ;iiid turn it outward with the for-ceps {a); wrap tlie proximal iiid in moistened, sterilized gauze and raise the
Size: 1458px × 1714px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
