Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . nted intothe colon without the necessity of making another blind end. The simplestoperation is that described above for lateral anastomosis. One bowel isclamped laterally and the other transversely. An opening is made in thefirst, as far as possible from the mesenteric border, and slightly longer than 666 SURGICAL TREATMENT the diameter of the afferent bowel. A through-and-through suture unites thewound edges circumferentially, and a musculoserosa suture is applie
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . nted intothe colon without the necessity of making another blind end. The simplestoperation is that described above for lateral anastomosis. One bowel isclamped laterally and the other transversely. An opening is made in thefirst, as far as possible from the mesenteric border, and slightly longer than 666 SURGICAL TREATMENT the diameter of the afferent bowel. A through-and-through suture unites thewound edges circumferentially, and a musculoserosa suture is applied out-side of this. A. H. Gould devised an operation which obviates the danger of contractureof the opening (Operations on the Intestines and Stomach). The smallintestine is closed by a clamp about 8 cm. (3 inches) from its end, and thelarge bowel by clamps some distance from the site of operation. The endof the small bowel to be implanted is split along its antimesenteric side to cm {Y2 or 1 inch) (Fig. 1337). The projecting corners are cutoff, leaving an oblique opening. The distal bowel is opened longitudinally. Fig. 1334.—Lateral operation is about completed. A few stitches of the outer row remain yet to be taken. The clamps are loosened. on its antimesenteric side for about cm. (1% inches). Guides areplaced to invert the edges, and the mesenteric thread is united by a through-and-through suture (Fig. 1338). Other guides are placed and the suture iscontinued the same as that used in simple end-to-end anastomosis. For theseromuscular suture, which is the outer tier, an interrupted right-anglesuture or the interrupted mattress stitch of Gould is used. A continuousmattress suture may be employed. The mesentery of the implanted bowelis sutured to the colon and the peritoneum beyond it. Anastomosis with mechanical devices is employed less than devices used were recommended by the additional speed whichthey contributed to the oper
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
