. Operative surgery, for students and practitioners . Fig. 110.—Gastrostomy (Kader). Tube intro-duced through hole in stomach. The wall ofstomach is raised in two folds by four suturesthat have been inserted. Fig. 111.—Gastrostomy (Kader). Four suturesshown in Fig. 110 have been tied and two morefolds raised with four additional Fig. 112.—Gastrostomy (Eader). The four sutures of the second row havebeen tied. One suture at each end is left long to serve as tractor. OPERATIONS UPON THE STOMACH. 263 wall of the stomach, and should include the serous and muscularcoats only; they should n
. Operative surgery, for students and practitioners . Fig. 110.—Gastrostomy (Kader). Tube intro-duced through hole in stomach. The wall ofstomach is raised in two folds by four suturesthat have been inserted. Fig. 111.—Gastrostomy (Kader). Four suturesshown in Fig. 110 have been tied and two morefolds raised with four additional Fig. 112.—Gastrostomy (Eader). The four sutures of the second row havebeen tied. One suture at each end is left long to serve as tractor. OPERATIONS UPON THE STOMACH. 263 wall of the stomach, and should include the serous and muscularcoats only; they should not pierce the entire thickness of the wallof the stomach or enter the mucous membrane layer. It is well toreinforce the first row of Lembert sutures with a second row. Ifthe wound in the stomach is large, for example, after excision ofa portion of the wall of the stomach for ulcer, etc., the opening maybe closed with a continuous, through-and-through suture of catgutand then in addition to this a row of continuous Lembert suturesof silk are applied. These bury the through-and-through catgutstitch and bring the serous edges into accurate apposition. Before applying the sutures the surface of the stomach imme-diately adjacent to the wound should be swabbed with a wet bichlo-ride pad. If there is difficulty in closing the perforati
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