A surgical study : gastrotomy and gastrostomy / by J.H. Pooley.

  • Pooley, J. H. (James Henry), 1839-1897.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A surgical study : gastrotomy and gastrostomy / by J.H. Pooley. 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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    z ^77 ^ > O O O o 00 e I 3 n o o O 3 3. O' c 00 o - 3 rt X < ^3 N> NJ K> - K O* = ?0 tAl f < 1 (^ n = ^ ^ /-N 00 O n • •u o n ?> ^■ =r CD —1 t/l o. v; r> ^ 5 Jme ID KJ ,2 ■ I V K> o •C^ rr\ Hi —■ b2244709x ] Itpa/-tc i7i;f;/i';.\ cr (T> Ci9 00 c 0) 25 itself. Sedillot, its originator, made use of a crucial incision, in which he has been followed by only one other operator, Mr. Lowe, of the Norfolk and Lynn Hospital. lean not see any advantages to be derivedfrom this form of incision, and as it has obvious disadvantages, it may be dismissed with this bare notice. One surgeon, Fenger, of Copenhagen, is said to have operated by a transverse incision; but I have not been able to obtain access to the particulars of his case, and should think this method quite as objectionable as the last. *Eight of the operators have made a straight vertical incision along the left linea semilunaris, from the cartilages of the lower ribs more or less high up, according to fancy, and extending downAvard the necessary distance, say three or four inches; and this is the method described in Maunder’s Operative Surgery, London, 1870, under the strange, aAvk ward and barbarous term of gastro-stomachotomy ! Notwithstanding the general preference that has been given to it, I do not think this method the best. Several of the operators speak of considerable difficulty in reaching the stomach through this incision ; and in the in- stances in which I have had the opportunity of trying it on the dead body, I have found it very inconvenient indeed. It must be borne in mind that an incision that would answer very well in gastrotomy for the removal of foreign bodies, would bj' no means necessarily be as commodious in this case. In addition to not having a foreign body to guide us by its bulk and hardness, we have to search f jr an empty and contracted stomach in an emaciated subject, Avhere it is drawn far up under the arch of the diaphragm; and further- more, Ave need here an incision that will enable up to attach the stomach to the parietes with the least possible stretching. In point of fact, this tension on the sutures seems to have been the main cause of the fatal result in both Sedillot’s and * In three cases the mode of operating is mot mentioned.