A Manual of the Operations of Surgery: For the Use of Senior Students, House Surgeons, and Junior PractitionersBell, Joseph
Science
A Manual of the Operations of Surgery: For the Use of Senior Students, House Surgeons, and Junior Practitioners
Bell, Joseph
Surgery, Operative
In congenital herniæ, and small ruptures in children and young
boys, Mr. Wood uses rectangular pins in the following manner:--The
scrotum being invaginated (without any incision through the skin)
as far as possible up the canal, a rectangular pin, with a
slightly-curved spear-pointed head, is passed through the skin of
the groin to the operator's forefinger; guided by it, it is brought
safely down the canal, and brought out through the skin of the
scrotum just over the fundus of the hernial sac. A second pin is
passed from the lower opening (still guided by the finger) in an
upward direction, transfixing in its course the posterior surface
of the outer pillar of the superficial ring, its point being
brought out through, or at least close to, the first puncture made
by the first pin. The pins are then locked in each other's
loops--the punctures and skin protected by lint or adhesive
plaster,--and the whole is retained by lint and a spica bandage.
The pins should generally be withdrawn about the tenth day.
The author has now in many cases stitched with catgut the edges of the
ring after the ordinary operation for hernia with the best effect.
2. _For Femoral Rupture._--Cases suitable for operation are very
infrequent; but should such a one be met with, Mr. Wood proposes the
following operation on the same plan as the preceding. The hernia being
fully reduced and the parts relaxed by position, an incision about an
inch long should be made over the fundus of the tumour, and its edges
raised so as to admit the finger fairly into the crural opening. The
vein is then to be pushed inwards, and the needle passed through the
pubic portion of the fascia lata of the thigh, and then through
Poupart's ligament, appearing on the skin of the abdomen, a wire is then
passed through the eye of the needle and hooked down, appearing through
the wound, it is then withdrawn, and the needle again passed through the
pubic portion of the fascia lata, but about three-quarters of an inch to
the inside of the first puncture, then through Poupart's ligament again,
and protruded through the same orifice in the skin; the other end of the
wire is then hooked down as before, leaving a loop above, at the needle
orifice, and two ends at the wound in the skin below. Both loops and
ends must be managed as before.
The author after operating for the relief of strangulation in a
case of very large femoral hernia in a girl aged 23, stitched up
the neck of the sac, and also stitched it to Gimbernat's ligament.
The result for some months was admirable, though the hernia had
been a very difficult one to replace from its size, and had been
long in the habit of coming down. Eventually protrusion occurred to
a very slight extent, but a truss keeps it completely up.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account