. American practice of surgery ; a complete system of the science and art of surgery . ^ the nse of the Murphy button, as shown in Fig. 128, but itmay also be accomphshed by means of the Connell suture, or by means of arow of deep sutures and a superficial row of Lembert sutures. The same istrue of the anastomosis between the end d, of the jejunum, and the opening ein the stomach. The diagram of the completed operation is shown in Fig. 127,the two branches of the jejunum forming the letter y. In this operation thesuture method is replacing that by means of the button in the hands of mostsurgeo
. American practice of surgery ; a complete system of the science and art of surgery . ^ the nse of the Murphy button, as shown in Fig. 128, but itmay also be accomphshed by means of the Connell suture, or by means of arow of deep sutures and a superficial row of Lembert sutures. The same istrue of the anastomosis between the end d, of the jejunum, and the opening ein the stomach. The diagram of the completed operation is shown in Fig. 127,the two branches of the jejunum forming the letter y. In this operation thesuture method is replacing that by means of the button in the hands of mostsurgeons. This operation can be performed as an anterior or as a posterior gastro-. FiG. 123. -Diagram. Showing the Third Stage of the Operation. A single tie lias been made inthe McGraw ligature (I) and the silk cord (b) is in place but still untied. enterostomy. In case the anterior gastro-enterostomy is employed, the loopmust be twice as long as when the posterior gastro-enterostomy is is of course a serious objection to this, in that it eliminates all that portionof the chiodenum and the jejunum which lies between the point a and the point6 (Fig. 126) from contact with food in the process of digestion. The second objection is to be found in the fact that, if an anterior gastro- SURGICAL DISEASES OF STOMACH AND (ESOPHAGUS. 359 enterostomy is made by this method, the branch of the duodenum, a b (Fig. 126),will l^e behind the omentum and colon, while the other jjortion, a c, will l^e infront of these structures—a condition which is likcl}^ to produce a consideral)leamount of tension. Moreover, unless the mesenteiy of the jejimum is unusu-ally long,
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
