Atlas and epitome of abdominal hernias / by Dr. Georg Sultan.

  • Sultan, Georg.
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and epitome of abdominal hernias / by Dr. Georg Sultan. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    removed. AA'hen removed, it should be tied off in small portions and never ligatured en masse, a procedure which has caused death in a number of instances.—Ed.] The sac is then cut oif one centimeter below the ligature and the stump is buried in the abdominal cavity. Second step: The isolated spermatic cord is lifted up and held to one side. The two flaps of the aponeurosis of the external oblique muscle are held back by retractors, and the whole mass of muscle situated internally—the larger upper portion, composed of the internal oblique and transversalis muscles, the smaller lower portion, com- posed of the rectus muscle—is united throughout its entire extent with Poupart's ligament by four or five interrupted sutures, so that only a sufficient opening for the spermatic cord is left in the upper and outer angle of the wound (Figs. 55 and 6Q). TJiird step: The spermatic cord is laid upon the new^ly formed posterior wall of the inguinal canal, and the two flaps of the aponeurosis of the external oblique muscle are sutured over it, thus forming the anterior wall of the new inguinal canal. The operation is concluded by the suture of the cuta- neous wound. Kocher's Operation.—Kocher wishes to avoid the splitting up of the inguinal canal which must be made in Bassini's operation and performs an operation which he designates as the lateral displacement method, and which may be divided into four steps. First step (Fig. 58) : The skin is incised in the direc- tion of the inguinal canal, the length of the incision being somewdiat greater than that of the canal. The incision is