Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . 4, inches) above the lowerborder ]of the stomach and parallel with it. Clamps are then placed on the VOL. II—30 466 SURGICAL TREATMENT stomach to prevent the escape of stomach contents when the incision ismade. The division of the stomach should be carried as far up toward thecardia as the entrance of the left epiploic artery will permit, as every gainpossible in the length of the tube is of advantage (Fig. 1140). The stomach wall, through both thicknesses, is div
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . 4, inches) above the lowerborder ]of the stomach and parallel with it. Clamps are then placed on the VOL. II—30 466 SURGICAL TREATMENT stomach to prevent the escape of stomach contents when the incision ismade. The division of the stomach should be carried as far up toward thecardia as the entrance of the left epiploic artery will permit, as every gainpossible in the length of the tube is of advantage (Fig. 1140). The stomach wall, through both thicknesses, is divided with scissors justbelow the line of suture. A piece of cloth is wrapped over the cut edge ofthe stomach, and the free edge converted into a tube by suturing the twofree edges together. This is done by continuing the first suture onto thetube. A second suture, whipping over the free edge is applied to stomach. Fig. 1139.—Gastroesophagoplasty, Method of Jianu. First Stage. The omentum is tied and cut from the stomach. For the sake of demonstration, the wound is here shown larger than would be made for surgical purposes. and tube (Fig. n 41). The open end of the tube is temporarily invertedwith a couple of sutures. This constructs a tube from 18 to 25 cm. (7 to 10inches) long (Fig. 1142). The stomach is then placed so that the base of the tube lies at the upperend of the abdominal wound, where it is made fast by a few sutures and thetube brought out into the open. The rest of the abdominal wound is closedabout the tube. The tube is then placed on the skin along the left of thesternum to measure its length, a horizontal cut made, and the skin under-mined to receive it. The blood supply of the tube is so good that it may bepulled up on the stretch, and made to reach as high as the third or second pulling up the tube beneath the skin, by means of forceps, the mucousmembrane is suture
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
