Annals of surgery . ew of interior ofstomach, showing oblique manner in which tube passes through the wall of thestomach when introduced by Witzels method. greatly emaciated, he had employed what he believed was Brauns de-vice, dividing the different layers of the stomach one after another,and stitched each one as it is divided to the walls of the abdomen,stitching the outer wall of the stomach to the peritonaeum and fascia,and so on, finally severing the mm ous membrane of the stomach andsuturing it to the outer integument, lie regarded that as a vet \ goodmethod, one which would prevent infe
Annals of surgery . ew of interior ofstomach, showing oblique manner in which tube passes through the wall of thestomach when introduced by Witzels method. greatly emaciated, he had employed what he believed was Brauns de-vice, dividing the different layers of the stomach one after another,and stitched each one as it is divided to the walls of the abdomen,stitching the outer wall of the stomach to the peritonaeum and fascia,and so on, finally severing the mm ous membrane of the stomach andsuturing it to the outer integument, lie regarded that as a vet \ goodmethod, one which would prevent infection of the peritonealcavity. GASTROSTOMY FOR CANCER OF THE OESOPHAGUS 595 Dr Will? Mi \ 11; also demonstrated the oesophagus and stoma* b of a man, fifty-nine years of age, on whom gastrostomy had been [in-formed by him according to Witzels method for cancerous strictureof the oesophagus at the German Hospital, on January 23, 1893.(Fig. 1.). Four methods of performing gastrostomy are recognized at thepresent time:. FIG. 2.—Witzels method for < Gastrostomy, showing application of sutures in wallof stomach embedding tube obliquely therein. (1) That of Fenger. An incision is made parallel to the left border of the ribs, withdivision of the abdominal wall in the same line, and stitching of thestomach to this wound. The opening of the Stomach is done at thesame sitting, or two days later. This operation was at presentpractically abandoned, on account of the difficulty in preventing 596 NEW YORK SURGICAL SOCIETY. leakage. Dr. Meyer had performed it only twice, and had also beengreatly annoyed by that symptom. (2) That of von Hacker. First recommended in 1886. A longitudinal incision is made to the left of the linea alba, withblunt division of the belly of the rectus muscle, and suturing of thestomach to the borders of the peritoneal wound. The rectus muscleacts as a sphincter. (By crossing the fibres of this muscle the muscularocclusion can be still improved. Girard.) Its meri
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
