Talma operation for cirrhosis of the liver : with report of cases / by Edgar A. Vander Veer.

  • Vander Veer, Edgar A., 1873-1953.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Talma operation for cirrhosis of the liver : with report of cases / by Edgar A. Vander Veer. 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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    profuse for some seventy-two hours, then subsided and glass tube removed and replaced by a wick of iodoform gauze. The patient improved and for a short time it seemed as though he was going to be decidedly benefited, but he died from apparent exhaustion at the end of the third week. No autopsy was held, but it xx^as not thought to be a case of infection. It may be said that this first case was not a particularly encour- aging one for operation. Among pro essional friends the operation xx'as looked upon as rather doubtful and not much encouragement given to repeat it. So that quite two years elapsed before the second patient presented in xvhom it was thought xx'ise to advise surgical interx'cntion. This case was more favorable and in the interim more operatix'e cases xx’ere reported. Case II.—He xx-as aged about fifty-one years, of fairly good habits, but jiresented the ex'idence of cirrhosis of the lixTr, xxuth abdominal dropsy, and had been tapped twice. Incision x\-as made from the ensiform cartilage downward and to the left of the umbilicus, permitting a very free xdew of tlie cirrhotic fixer and contents of the abdominal caxdty. In this case there xx’as plenty of omentum, and two folds on each side of the upper portion of the incision, four to six inches transx’^ersely, forming two terraces, as it were, xvere brought up and sutured to the under surface of the abdominal wall with interrupted silk sutures. Tliis patient did xvell, improx’ed decidedly, he and his friends xx’ere greatly pleased, and one year after the operation xx'as doing nicelx'. The patient then mox’ed elsewhere and the final result in his case xvas nex'er learned. Remarks by Dr. A. \'ander ^'eer: “ I have removed the ox'aries imder local anesthesia successfully, but would hardly be xvilling to attempt such an operation as omentopexy xxdthout gixing the patient a general anesthetic. In neither of these cases was any attempt made to roughen the surface of the fiver and spleen, although in the second case the lix’er xvas handled quite a bit, but no drainage xvas employed. The cases xvere somexvhat nox'el to me. I have talked about them since xx'ith the late