. Manual of operative surgery. ole and spread the rubber dam as a protection over the whole territory P^^ . of operation so that no stomach con-tents can soil the abdomen. The clamped jejunum can be palpated throughthis rubber sheet and when it is needed the rubber can be incised. Step 5.—Make a free cut across the greater curvature at a point chosen sothat the tip of the greater curvature flap will easily extend to the point ofdivision on the lesser curvature (Fig. 517). The gastro-epiploic vessels are ofcourse ligated at the point of section. It is the fact that both curvatures are sutured t
. Manual of operative surgery. ole and spread the rubber dam as a protection over the whole territory P^^ . of operation so that no stomach con-tents can soil the abdomen. The clamped jejunum can be palpated throughthis rubber sheet and when it is needed the rubber can be incised. Step 5.—Make a free cut across the greater curvature at a point chosen sothat the tip of the greater curvature flap will easily extend to the point ofdivision on the lesser curvature (Fig. 517). The gastro-epiploic vessels are ofcourse ligated at the point of section. It is the fact that both curvatures are sutured transversely that makesthem so much easier to suture and turn in than when one is dealing with acorner or a point. By this method the corners come in the free part of thestomach where there is no tension. When the cut in the greater curvature is made, the latter is held up sothat when it is divided nothing but gas will escape. Beginning on the greatercurvature near the pylorus cut through both the anterior and posterior walls. 384 THE STOMACH on a line directed towards the oesophagus and so excise the whole lesser curva-ture. At this point all of the stomach can be carefully cleaned out and in-spected as far as the oesophageal clamp. If necessary the clamp can also beremoved and still more of the lesser curvature excised. If the two main vesselsare tied, the hemorrhage from the free edge may be ignored for a few completing the section it is well to apply forceps or a stout stitch to thestomach near the oesophagus and proximal to the line of section in order toinsure against the stump slipping through the intestinal clamp. Ligate thecoronary vessels. Step 6.—Incise the rubber dam and secure the clamped loop of the greater curvature of the stomach at a suitable place over it having madea button hole in the posterior wall. Through this pull the loop of jejunum(the clamp remaining outside the stomach). Working inside the stomach,open the loop of jejunu
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