. Operative surgery, for students and practitioners . ylorus and body of the stomach, all ofthe lesser curvature, and a considerable part of the greater curvature,together with all the adjacent lymphatic nodes are removed in onemass, the fundus only remaining; the continuity of the alimentarycanal is restored either by a gastro-duodenostomy or a gastrojejunos-tomy. The abdominal incision must be sufficiently liberal, reachingfrom the tip of the ensiform cartilage downward in the middle lineas far as the umbilicus or beyond that point. If still more roomis required a transverse incision may be
. Operative surgery, for students and practitioners . ylorus and body of the stomach, all ofthe lesser curvature, and a considerable part of the greater curvature,together with all the adjacent lymphatic nodes are removed in onemass, the fundus only remaining; the continuity of the alimentarycanal is restored either by a gastro-duodenostomy or a gastrojejunos-tomy. The abdominal incision must be sufficiently liberal, reachingfrom the tip of the ensiform cartilage downward in the middle lineas far as the umbilicus or beyond that point. If still more roomis required a transverse incision may be added, reaching toward theright partly or completely through the rectus muscle. The hand is OPERATIONS UPON THE STOMACH. 275 introduced into the abdomen and the conditions investigated. Asa rule, the stomach, tumor, can be brought out through the the tumor cannot be drawn out thus, because fixed by dense ad-hesions and by the extension of the disease to the surroundingorgans,—pancreas, liver, spleen, diaphragm, etc.,—then the case is. Fig. 118.—Doyen Compression Forceps. probably not a suitable one for this radical operation, but rather fora palliative gastrojejunostomy. Inflammatory adhesions that arenot too dense may be broken up with the fingers. The liver, etc.,are retracted upward by the assistant and the stomach seized bythe operator and drawn downward and the index finger of the lefthand poked through the gastro-hepatic omentum. In this way the
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