File:A new manual of surgery, civil and military (1917) (14764265664).jpg

Identifier: newmanualofsurge00ochs (find matches)
Title: A new manual of surgery, civil and military
Year: 1917 (1910s)
Authors: Ochsner, Albert J. (Albert John), 1858-1925 Percy, Nelson M. (Nelson Mortimer), b. 1875
Subjects: Surgery
Publisher: Chicago, Cleveland Press
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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disable him for worknot longer than one month. There can consequently be little doubt concern-ing the wisdom of his choice of treatment. Preparation for operation. The intestinal canal should be thoroughlyemptied by the administration of two ounces of castor oil the day before opera-tion, followed by a large soap and water enema that evening and anotherearly the morning of operation. The field of operation should be shaved theevening before and the following morning the patient should take a hot soapand water tub bath. As soon as the patient is anesthetized the skin area is 338 GENERAL SURGERY OF THE ABDOMEN washed thoroughly with soap and water (bemg careful not to cause irritation),then it is washed Avith 1 to 2,000 bichloride solution, then with alcohol. Thesurface is dried and painted with full-strength, compound tincture of iodine.Operative technique. An incision ten to fifteen centimeters in length ismade in the direction, and over the center, of the inguinal canal, beginning at
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Ferguson s Operation for Inguinal Hernia. T. F., transversalis fascia; I. R., internal ring; P. L., Pouparts ligament; I. O., internaloblique muscle; A, aponeurosis of the external oblique muscle; C, cremaster muscle; C. T.,conjoined tendon. a point two centimeters above the scrotum. This is carried through the skinsuperficial fascia and fat, exposing the fascia of the external oblique abdominalmuscle with the hernial sac protruding at the lower end of the inguinal canal.The fascia of the external oblique is now slit up in the direction of theinguinal canal to a point five centimeters above the internal abdominal ring.The edges of this are now carefully retracted, and the soft tissues, consistingof fat, portions of the cremaster muscle and connective tissue, are carefully GENEEAL SUEGERY OF THE ABDOMEN 339 dissected away, leaving the anatomical structures plainly exposed. The fatcan be removed most perfectly and rapidly by stripping bet\Yeen the layersof a piece of moist gauze held be

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