A manual of operative surgery / By Lewis A. Stimson ... and John Rogers.

  • Stimson, Lewis Atterbury, 1844-1917.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A manual of operative surgery / By Lewis A. Stimson ... and John Rogers. 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.

    558/628 (page 554)
    After all the ligatures have been passed, a silver wire, about twelve inches long, is fastened to the loop of the first ligature (Fig. 278, C), and drawn through with the help of the fork. The silk is cut off, the ends of the wire drawn aside out of the way, and the others passed in the same manner. Simon used fine silk sutures (two rows when the fistula was large) tied in the ordinary manner, and often passing through the vesical mucous membrane (Fig. 279). The ends of the silver sutures being drawn together, and the edges of the wound carefully approximated, each thread is slightly twisted so as to keep the parts in apposition, and then the ends of the first are seized with forceps and twisted with the help of the shield (Fig. 275), as shown in Fig. 278 ; care being taken not to twist so tightly as to strangulate the tissues engaged in the loop. The other sutures are then twisted in the same manner, and the ends of each cut off about half an inch from the surface (Fig. 280). FiG. 280. -MrMv The bladder is then syringed to remove any blood that may have collected in it, ami a catheter passed into it and left there. The sutures may be removed during the second week. Creation of <i Veaico-vagirwl Fistula.—Tin- operation i- sometimes required in the treatment of chronic cystitis. Dr. Knunet ' perform- it as follows: Amestliesia ; Simp's position. A Sim-'- speculum is introduced into the vagina and ;i director, abruptly curved an inch and a- 1 Chronic CyBtitU in the Female, American Practitioner, February, l-7'_\ ;nnl Veaico-vaginal Fistula, \>. 43.