File:Operative surgery (1899) (14779759645).jpg

Identifier: operativesurgery02brya (find matches)
Title: Operative surgery
Year: 1899 (1890s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914
Subjects: Surgery, Operative Surgery, Operative
Publisher: New York : D. Appleton and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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terior to the central line, and must be sought fornear the hollow of tlie sacrum.- During the entire progress of the dissec-tion the situation of the vagina or urethra must be marked by the location66 948 OPERATIVE SURGERY. of the sound previously introduced. When the dark-brown, fluctuatingextremity of the gut is detected, the introduction of a hypodermic needle will settle all doubt. The gutend should then be seized by astrong, toothed forceps (Fig.11G9), and drawn firmly down-ward, while its connections withthe surrounding tissues are sepa-rated by the scissors and fingers.As soon as the cul-de-sac is drawndown to a level withthe external opening,two short ligaturesare passed transverselythrough the sides ofthe wound (J, e), orthrough its anterior and posteriorextremities, transfixing in eitherinstance the walls of the bowel intheir passage, but not enteringthe lumen of the gut. Protectthe raw surfaces with lint satu-rated with carbolized oil, thenopen the sac between the ligatures
Text Appearing After Image:
Fig. 1168.—Operation for absence of anus. a.Border of cutaneous incision, b. End ofbowel, c. Perirectal tissue, d. Extremityof coccvx. e. Scrotum. and allow the contents to escape; afterhaving thoroughly cleansed the parts, re-move the lint and unite the border ofthe sac with the anus by interrupted silk-worm-gnt sutures (Fig. 1170). Cleansethe bowel thoroughly, and introduce asmall, coaptating plug of iodo-form gauze perforated by a good-sized rubber tube (Fig.1171, e) to exclude fa?ealmatter from the line ofsewing, and to permit theescape of intestinal gases at the sametime. The mucous membrane shouldbe closely adjusted to the integument, inorder to secure perfect union and pre-vent the contact of the raw surfaceswith the discharges. If it be impossible to draw the end of the gut down to the Fig. 1169.—Operation for absence of . 1 • •, I-Ti-i. anus. a. Sutures at anterior aspect external opening, it can be incised at its ^f ^^^^.i. ^^e posterior one may pass lower extremitv,

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