File:Text-book of operative surgery (1903) (14761196681).jpg

Identifier: textbookofoperat1903koch (find matches)
Title: Text-book of operative surgery
Year: 1903 (1900s)
Authors: Kocher, Theodor, 1841-1917 Stiles, Harold J
Subjects: Surgery, Operative Surgery
Publisher: London : Adam and Charles Black
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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y exposed to view, somemethod of simplifying the procedure may be sought. The most valuable means wehave of effecting this is by using a Murphys button. Other methods, such as thosedescribed by Maundsell and recommended by Ullmann, are also reliable. In thismethod the upper end of the gut is invaginated, and the invaginated end is broughtout through a lateral longitudinal incision higher up. The lower end is pushed Fig. 118.—Resection of intestine: second step. The disease*) piece ol intestine has been removed ; theends of the intestine are compressed between the assistants fingers, and fixed in position by two fixation sutures, one at the concavity ami the othi r a1 the convexity ; the po terior con-tinuous suture has been introduced through the whole thickness of the wall. Place wherethe mesentery (■Second fixation suture (uniting the two corresponding parts at theI convexity of the intestine). (Posterior continuous suture penetrating the\ whole thickness of the intestinal wall.
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f Continuous serous suture\ (the first loop knotted). / End left with which the terminationI of the continuous suture is knotted. Deep continuous suturethrough the entire thick-ness of the wall (first knotat the mesenteric attach-ment). Deep continuous suture through the entire thickness of the wall (first knot at the convexity). termination of the con-( tinuous suture is knotted. Continuous serous suturefor the post, segment. -Intestinal suturing ; to demonstrate the double row of sutures ; posterior half of gutcut longitudinally ; viewed from within. 264 OPERATIVE SURGERY through the iiivaginated upper end so that both can be ligatured over a turnip bobbinand drawn back again. With regard to suture of the intestine Chlumsky has made some very interestingexperiments. He has shown that sutures give a much more reliable mechanical unionthan Murphys button; and further, the suture is more reliable on the first day andshortly after the operation than on the days immediately following. Th

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