572 



LAPAROTOMY. 



operation is sanctioned. Siedamgrotzky, however, was successful 

 with a dog which had swallowed a large flint stone. Adam removed 

 a grape shot from the stomach by gastrotomy, and effected a cure. 

 The strictest antisepsis is, however, necessary. After narcotising 



Fig. 403. 

 Gely's bowel suture. 



Fig. 404. 

 Lembert's bowel suture. 



Fig. 405. 

 Wolfler's bowel suture. 



the dog with morphine, followed by aether, or throughout with chloro- 

 form, the lower surface of the abdomen between the umbilicus and 

 sheath or umbilicus and pubis is shaved and disinfected. The skin 

 is then cut through close to the linea alba, and the muscular tissue 

 divided for a distance of 2 to 3 inches. The peritoneum is next 

 punctured, a finger introduced into the cavity to prevent injury to 

 the bowel, and the peritoneum finally divided to the same extent 



Fig. 401). 

 Lembert's suture. 



Fig. 4(17. 

 Czerny's suture. 



as the abdominal wall. Two or three fingers are now introduced into 

 the peritoneal cavity, and the foreign body sought. To prevent 

 prolapse of the bowel, the left hand, or, preferably, a cloth saturated 

 with disinfecting fluid, is laid on the wound. Frick passes one or 

 more silk sutures through the entire thickness of each lip of the wound 

 including the skin, muscles, and peritoneum), and uses these sutures 

 to hold apart or to approximate the edges. 



It often takes some time to discover the obstructed piece of bowel, 

 and one must not lose patience. As soon as the part is felt, it should, 



