A new method of performing circular enterorrhaphy / by F.T. Paul.

  • Paul, F. T. (Frank Thomas), 1851-1941.
Date:
[1891]
Catalogue details

Licence: Public Domain Mark

Credit: A new method of performing circular enterorrhaphy / by F.T. Paul. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    parts are kept supported and at rest as by a splint. Decalcified bone answers the purposes required of it in these respects remarkably well. Firm, elastic, and yet too soft to damage the bowel, maintaining its rigidity during the first day or two, then gradually dissolving and melting away. In my experi- ments I resolved that decalcified bone should be the supporting material, and have had every reason to be satisfied with it. I had a number of bone tubes made about 1 inch long and suitable for tire calibre of dogs’ intestine. These were pre- pared in accordance with Senn’s directions. Altogether eleven experiments were made, of which the operation to be described was performed in eight consecutive cases. Four were allowed to live for long periods, and four were killed at early dates; but none were injuriously affected by the operation. Three dogs were operated upon with the object of elucidating points indirectly connected with the main subject. They all died in about thirty-six hours. In one the operation involved a partial resection of the coats of the intestine, which was followed by rapid sloughing and perforation. In another the mesentery was cut away from the colon for about 3 inches, and an en- terorrhaphy done at the spot. The bowel became gangrenous, though all reasonable care had been taken to save the vessels as much as possible. This operation was done in view of the obstruction offered by the human meso-colon to invagination of that portion of bowel. In the third of these experiments the ileum was cut away from the caecum and connected with the rectum, the isolated colon being closed by invagination at each end. Faecal matter contained in the colon was driven by peristaltic action to the lower end, when it formed a round ball which burst open the Lembert sutures and liberated the in- vagination. The sutures in the mucous membrane held but permitted the exudation of a little fluid from the intestine into the peritoneal cavity. This must have been rapidly fatal, for the dog was left well on the second night, and had been dead some hours when seen the next morning. The attachment of ileum to the rectum was oing on quite satisfactorily.