. A manual of operative surgery . sure on thefemoral vessels nor undue tension on the stitches. In the cases followed up by one of us (J. H.) after a numberof years, recurrence of the hernia was found in only a very smallproportion. 2. Professor Rouxs Method.—This method requires little descrip-tion. A steel staple, shaped like the rectangular croquet-hoop, 368 ABDOMINAL OPERATIONS [PART II with both ends sharply pointed, is passed through Poupartsligament, as shown in Fig. 105. As before, care must be takennot to injure the femoral vein. The staple is hammered down intothe pubic bone. It is d
. A manual of operative surgery . sure on thefemoral vessels nor undue tension on the stitches. In the cases followed up by one of us (J. H.) after a numberof years, recurrence of the hernia was found in only a very smallproportion. 2. Professor Rouxs Method.—This method requires little descrip-tion. A steel staple, shaped like the rectangular croquet-hoop, 368 ABDOMINAL OPERATIONS [PART II with both ends sharply pointed, is passed through Poupartsligament, as shown in Fig. 105. As before, care must be takennot to injure the femoral vein. The staple is hammered down intothe pubic bone. It is difficult to drive the staple evenly intothe bone, and to facilitate the process a special instrument hasbeen devised by Professor Chiene. The staple is intended to remain in permanently, fixingdown Pouparts ligament close to the bone. It is obvious thatit is easy to make the ligament press too much on the femoralvein, so causing thrombosis. Dr. Crawford Renton and othersspeak favourably of Rouxs staple, which has been used some. FIG. 105.—DIAGRAM SHOWING USE OF ROUXS METAL STAPLE IN CLOSING THEFEMORAL RING (). The staple is passed through Pouparts ligament (), and into the pubic bone (p). It mustbe hammered down further to close the ring. A, Femoral artery; V, Vein; ,Gimbernats ligament. hundreds of times by its originator. In how many cases it willwork loose after a few years, possibly causing serious troublewithin the femoral vein, only further experience can show. Touse a steel staple in the average case of femoral hernia isunnecessary and inadvisable. 3. Mr. W. H. Battles Method.—A full account of this is givenin the Medical Societys Transactions for 1906, p. 343. Fromthis the following extract, with Fig. 106, will make it clear. Silkis used for the deep sutures, and the essential point is the draw-ing down of a flap from the inner pillar of the inguinal ring andits suture to the pectineal fascia. chap, xii] RADICAL CURE OF FEMORAL HERNIA 369 A vertica
Size: 2239px × 1116px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, booksub, booksubjectsurgicalproceduresoperative
