. Annals of surgery. ve an acute obstruc-tion, also in the oedematous condition associated with acuteperitonitis. It has been equally successful in the compensatorythickening associated with chronic obstruction. After resection of the head of the ascending colon, therehas been practically no difficulty in making end-to-end anas-tomosis between the ileum and colon of vastly different diame-ters. To illustrate the ease and speed with which the method SUTURING HOLLOW VISCERA. 527 can be applied, it is enough to state that a double resection withdouble anastomosis has been accomplished in about th
. Annals of surgery. ve an acute obstruc-tion, also in the oedematous condition associated with acuteperitonitis. It has been equally successful in the compensatorythickening associated with chronic obstruction. After resection of the head of the ascending colon, therehas been practically no difficulty in making end-to-end anas-tomosis between the ileum and colon of vastly different diame-ters. To illustrate the ease and speed with which the method SUTURING HOLLOW VISCERA. 527 can be applied, it is enough to state that a double resection withdouble anastomosis has been accomplished in about the sametime that the single operation of this sort formerly took wherecomplicated methods of bowel union were used. The Rouxgastro-enterostomy has been frequently used in my work re-cently, since this simplified suture has made it possible to per-form the operation in about the same time that was formerlyrequired for a posterior gastro-enterostomy alone. I have used this method for more than two years in every Fig. End-to-side anastomosis. operation which I have done upon the hollow viscera of theabdomen, a very large number of cases in all. That it is a thoroughly useful procedure, to say the least,is attested by the fact that only two of all of these patients diedin the hospital of any cause, neither of them with peritonealsymptoms; one expired sixteen days after a gastrectomy andthe other two days after an anastomosis between gall-bladderand stomach for the relief of biliary obstruction in cancer ofthe pancreas. 528 WILLARD BARTLETT. This method is safe, because all of the coats of a viscus areembraced and consequently every stitch has a firm foundation. No form of suture operation could be done more quickly,because the smallest possible number of stitches and knotsare employed. No permanent ill after effects are to be anticipated, sincea very scanty diaphragm is formed. The requirements of modern surgical technic are not satis-fied by any method of anastomosing hollow vi
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