Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ut the duo-denum, the ends of the catgut strands are cut short and the duodenal stump VOL. II—48 754 SURGICAL TREATMENT invaginated in a manner similar to the stump of an appendix in appen-dectomy. A second suture is now placed on the duodenum; behind, itcatches the pancreatic sheath so that the stump may be buried against thehead of the pancreas. Finally the stumps of the adjacent tied gastrocolicand gastrohepatic omenta are so adjusted by fine sutures as to give
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . ut the duo-denum, the ends of the catgut strands are cut short and the duodenal stump VOL. II—48 754 SURGICAL TREATMENT invaginated in a manner similar to the stump of an appendix in appen-dectomy. A second suture is now placed on the duodenum; behind, itcatches the pancreatic sheath so that the stump may be buried against thehead of the pancreas. Finally the stumps of the adjacent tied gastrocolicand gastrohepatic omenta are so adjusted by fine sutures as to give furtherprotection. The field of operation is searched for bleeding points andprotected with gauze. Xext the stomach is drawn to the right and holding clamps placed fromthe space cleared on the greater curvature to the space cleared on the lessercurvature. When the stomach is cut across these clamps sometimes slipnear the cardia and the stomach retracts. To prevent this Mayo uses apair of bayonet holding clamps which are placed on the proximal side fromabove downward, grasping the upper part of the stomach halfway across. A. Fig. 1427.—Partial Gastrectomy with Anterior Gastro-enterostomy. The pyloric end of the stomach has been removed, the duodenum closed and the jejunum anastomosed anteriorly to the stomach. clamp is now placed distally to prevent leakage from the end to be amputated,and the stomach divider] between. The divided proximal gastric surface iscauterized with the actual cautery and the stomach turned in by a continu-ous chromic catgut suture beginning on the greater curvature. This sutureis applied quite tightly. It starts on the mucous surface, passes throughall the coats to the peritoneum and back on the opposite side through allthe coats to the mucous membrane, and is then tied and the end suture now passes through all the coats from the mucous to the peri-toneal coat and begins on the opposite side by passing through all the coatsfrom the peritoneu
Size: 1710px × 1461px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, booksubjectsurgery, bookyear1920
