File:Interstate medical journal (1917) (14783676105).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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e, illustrating method of placingclamps, the line of incision distal to the valve, and the preservation of theileocolic vessels intact until after resection is completed. ileum, the valve, or the more pathological ceco-colon. Fig. 2depicts the Lardennois method, little known in this country. Thisoperation conserves more normal tissue than the preceding andat the same time some of the supposedly most diseased colon—thececum. Fig. 3 has been originated by the author to dispose of theobjectionable points of both of the above—namely, to conserve the INTERSTATE MEDICAL JOURNAL 15 good tissue, including the sphincter, and dispose of the bad. Thevalve may be advanced to any level along the colon, and thecollar may be trimmed to fit the cut end of the distal colon. TECHNIC OF ADVANCEMENT OPERATION. An incision of ample working size is made through the rightrectus. The abdomen is gently explored. Special attention is giventhe alimentary tract as a unit, bearing in mind what slight disorder
Text Appearing After Image:
Fig. 5.—One of a series of x-ray pictures taken by Dr. L. T. LeWald, illustratingcomplete clearance of the small intestine and site of sphincter six weeksafter a canine advancement operation. in one part may upset the balance of other parts of the stomachand intestine. In removing the right colon, the portion to be re-moved—the cecum, ascending and perhaps the omentum-free endof the transverse colon—is gently drawn out and separated fromthe remaining abdomen with gauze. Commencing from the lowerright side, the peritoneum is divided as closely to the line of colonicreflection as possible. Starting from above and mesially, the same 16 INTERSTATE MEDICAL JOURNAL separation of peritoneum is continued down to the ileocecal vessels.The vessels above the ileocecal vessels are next ligated and divided.The colon is incised between clamps below, as illustrated, and atthe plane determined on above. The ends of the iliocecal vesselsare caught and ligated only as they appear in the cecal col

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