Modern methods of intestinal anastomosis / by August Schachner.

  • Schachner, August, 1865-1941.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Modern methods of intestinal anastomosis / by August Schachner. 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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    2. The highest degree of vascularity in the stomach is along its curvatures, and the lowest degree is at a point mid- way between its curvatures. Throughout the entire intes- tinal tract there is an absence of the serous coat at the mes- enteric border. 3. In view of the diminished vascularity and the constant presence of the serosa at a point midway between the curva- tures in the stomach and opposite the mesenteric border in the intestines, these regions should be regarded as the lines of safety, and when permissible should always be given the preference in all operative measures. 4. The dangers of sepsis, hemorrhage, peritonitis, and non-union increase in direct ratio as we recede from the lines of safety. 5. The strength of a continued or Glover's suture is measured practically by its weakest stitch; if this tears, the remaining stitches are all more or less loosened and the end nearly always defeated. 6. Barring certain exceptions the continued or Glover's stitch is the most rapid, most uncertain, and most uneven stitch that can be applied. 7. No method of intestinal resection, however simple it may be, will receive full justice in the hands of even the most ingenious surgeon at its first performance. For this reason it should be the duty of all those expecting to engage in such work to thoroughly train themselves in intestinal operations in a practical way, either on lower animals or upon the dead subject. 8. The end-to-end method of restoring the continuity of the intestine in resections is attended with the least contrac- tion and affords the most natural restoration of the intestinal canal. 9. The opening in all lateral anastomosis should be abundantly large (four inches) to allow for subsequent con- traction, which always takes place to a considerable degree.