File:A new manual of surgery, civil and military (1917) (14786584873).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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portion of the bladder and to observethe direction in which the probes extend into the ureters. In this mannerinjury to the latter is readily avoided. The segment of the bladder, together 570 SURGERY OF THE GENITO-URINARY TRACT Avith the ureters, is now held upwards, the urine which issues from the uretersis sponged gently, and the remaining portion of the bladder is rapidly dissectedaway. Then the sigmoid tiexure is brought up into the wound and a longi-tudinal incision made through the middle of the longitudinal muscular band,two centimeters in length. The segment of the bladder is inserted into thecolon and held in place with four silk stitches, two at the end of the longi-tudinal incision in the colon and one in each edge of the incision half waybetween these two stitches. Four sutures are previously placed in the wall ofthe colon, one on each side of the middle of the incision and one just beyond theend of the incision, to be utilized for the purpose of manipulating the intestine
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Removal uj- i ^ai.-, aau .-iukotxjm for Carcinoma. ij. j--4^pf>c-. Withperineum, excision of inguinal lymphatics and transplantation of stump of urethra intoshowing primary incision. while the segment of the bladder is sutured in place. The first row of suturesis passed through the entire thickness of the bladder and through the entirethickness of the intestine, care being taken to repeat about the fourth stitchin the continuous suture in order to prevent slipping—after the mannerdescribed in the section on intestinal surger3\ After the entire segment of thebladder has been sutured into this opening, Avith the mucous membrane facingthe lumen of the intestine, a second row of sutures is applied which penetratesneither the portion of the bladder nor the intestine, but simply grasps a suffi-cient amount of tissue to bring the serous surfaces carefully and thoroughly inapposition throughout the entire course. The intestine is then dropped intothe abdominal cavity. Care must then be t

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