OPERATIONS 



900 



OPERATIONS 



of the bowel is deferred, if possible, until the third 

 day. Allingham's (W.) : I. For excision of the 

 rectum ; the patient in the lithotomy position, an 

 oval incision is made into both ischio-rectal fossae, 

 around the bowel, and prolonged backward to the 

 coccyx ; the bowel is isolated, and separated with 

 the ecraseur, scissors, or Paquelin cautery. 2. For 

 hemorrhoids; the pile is dissected off from the mus- 

 cular tissue with scissors, the pedicle ligated, and the 

 mass cut off. Alonette's, for amputation at the hip- 

 joint ; a semicircular external flap is made, extending 

 to the great trochanter, with disarticulation of the head 

 of the femur, and the making of a large internal flap 

 by cutting from within outward. Alquie-Alexan- 

 der's. The same as Alexander's. V. Amnion's : I. 

 Blepliaroplasty ; removal of all cicatricial tissue and 

 freeing of the remains of the lid, followed by transplan- 

 tation of a flap from the cheek. 2. For destruction of 

 the lacrymal sac ; incision into, and excision of, a 

 portion of the anterior wall of the sac ; closure by adhe- 

 sive inflammation. 3. For ectropion (from caries) ; an 

 incision is made around the cicatrix, the tissues are dis- 

 sected free, and after closing the lid the wound is closed 

 over the cicatrix. 4. For symblepharon ; the lid is di- 

 vided, by two converging incisions, into three portions 

 — two lateral and a central wedge-shaped portion ; the 

 former are united by sutures, and after union the central, 

 wedge-shaped part is dissected out. Amussat's : 

 I. A method of arresting hemorrhage by torsion of 

 the arteries by means of two forceps. 2. For. atresia 

 vagina ; dilatation by the use of the finger or a dull 

 instrument, without cutting. 3. For castration ; by 

 incision upon the posterior surface of the scrotum. 4. 

 For enterorrhaphy ; in cases of completely divided 

 intestine, each end is invaginated and passed over a 

 cork, with a groove at either end, and the intestine is 

 tied in the grooves. 5. For imperforate rectum ; the 

 formation of an artificial anus in the perineum, with 

 or without excision of the coccyx. 6. For lumbar col- 

 otomy ; a transverse incision is made, crossing the outer 

 border of the quadratus lumborum muscle. Anagnos- 

 takis' : I. For entropion ; an incision is made parallel 

 and close to the free margin of the upper lid, a horizontal 

 fold of skin, with the underlying tissue, is excised, 

 and the wound closed by sutures. 2. P 'or trichiasis ; 

 the offending cilia are included between two perpen- 

 dicular incisions and excised. Anderson's, for length- 

 ening tendons ; the tendon is split longitudinally, the 

 cut surfaces slid along, and sutured. Anel's : I. For 

 aneurysm ; ligation on the cardiac side close to the 

 aneurysm. 2. For stricture of the lacrymal duct ; 

 dilatation by means of a gold probe, followed by the 

 injection of an astringent fluid into the sac. Anger's : 

 I. For hypospadias; the formation of a urethra by 

 superimposing a quadrilateral flap from one side and 

 lower border of the penis, over another flap from the 

 other side, which has been turned over a catheter. 2. 

 For ingrowing toe-nail ; the lateral-flap operation, with 

 removal of the diseased portion of the matrix. 3. For 

 union of divided tendons; the use of "distance-sutures, ' ' 

 when the ends of the tendon are widely apart. Annan- 

 dale's : I. For dislocated cartilages ; incision into the 

 knee-joint and stitching of the dislocated cartilages 

 into their proper position. 2. For genu valgum ; 

 partial excision of both condyles of the femur. 3. 

 For naso-pharyngca! polypus ; division of the alveolar 

 margin and palatal portions of the upper jaw along 

 their center, from before backward, and perforation of 

 the bony septum of the nose, thus permitting separa- 

 tion of the two portions of the bone and exposure of 

 the polypus. 4. For varicocele; a modification of 

 Lee's operation, the veins only being excised, the 



scrotum being left intact. 5. For webbed-fingers 

 the longitudinal incisions are made along the sides of 

 each finger. Antal's, for tumor of the bladd, 

 after a supra-pubic incision the tumor is removed will 

 the portion of the bladder from which it springs, am 

 the vesical wound is closed ; the peritoneum is rollei 

 up and not opened. Antyllus', for aneurysm; i 

 consists in ligation above and below the sac, followe( 

 by opening of the aneurysm and evacuation of its con 

 tents. Antyllus-Kuhnts', for paralytic ectropion 

 excision of a wedge-shaped portion of the conjunctivi 

 and tarsus from the lid, in order to shorten the latter 

 The base of the wedge is on the free border of th< 

 lid. Apostoli's, electrolysis of a uterine fibroid who 

 an electrode cannot be introduced into the womb 

 One broad abdominal electrode is used, and a spear 

 pointed electrode is thrust through the vaginal wal 

 into the tumor. Appolito's, for enterorrhaphy, h 

 means of a form of right-angle continuous suture 

 Argyll Robertson's : 1 . For entropion ; a piece of 

 sheet-lead is fastened inside of the lid, so that th< 

 pressure will cause absorption of the hypertrophii 

 tissue. 2. For glaucoma ; trephining the sclerotic fn 

 the relief of pain. 3. For pterygium ; the growth i 

 separated and excised; the conjunctiva, previou^] 

 dissected up, is brought over the wound and sutured 

 Arlt's : I. For blepliaroplasty ; a modification of Diet 

 fenbach's operation, with a downward inclination of thi 

 cantho-temporal incision, and a slight deviation of thi 

 tempero-genal incision. 2. Fox cicatricial ectropion 

 a V-shaped incision is made, removing the cicatrix; Uu 

 wound is closed by interrupted sutures. 3. For entro 

 pion ; [a) a modification of Gaillard ' s suture ; a thread 

 with a needle at either end, is passed subcutaneousl; 

 from the margin of the lid down to the cheek, and thi 

 two ends are tied ; there results a puckering of the skii 

 and thereby relief of the entropion ; (b) a flap-splittin. 

 operation upon the lid, with the removal of an oval poi 

 tion of the skin, and suturing of the latter. 4. Yoxenu 

 cleation of the eye ; Desmarre's retractors are introduced 

 and the conjunctiva is divided all around the cornea 

 junction ; then the external rectus (if the left eye, th< 

 internal if the right eye) is caught by a blunt hook an< 

 divided behind it, leaving a stump ; then the remain 

 ing ocular muscles and the optic nerve are divided b; 

 scissors. The internal rectus (if the left eye, the exter 

 nal if the right eye) and the two oblique muscles ar- 

 divided after luxation of the ball in front of the lids 

 the conjunctiva is stitched in and out, so as to form ; 

 suture like the string of a tobacco-bag, and a | 

 bandage is applied. 5. For median tarsorrhaphy : exci 

 sion with scissors and forceps of a narrow strip of skii 

 from both the upper and lower lids, close to their inne 

 angle, meeting on the inner side of the inner 

 sure; they are then united by interrupted suti 

 For stricture of the lacrymal duct ; incision of the ar 

 terior wall of the sac, evacuation of the pus and gradua 

 dilatation of the duct. 7. For symblepharon ; di 

 of the symblepharon, and suturing of the flap 

 8. For trichiasis ; known also as the Jaesche 

 tion : it is a modification of Jaesche' s operation, 11 

 which the lid is separated into anterior and posters 

 flaps by Flaref 1 s incision. Arlt-Jaesche. 

 chiasis ; the edge of the lid and the contaim 

 bulbs are dissected from the tarsus, a crescent 

 piece of skin is removed from the lid above the fi: 

 and the edges of the wound are united, thus trni 

 planting the ciliary bulbs further away from flu 

 the lids. Armsby's, for the radical cure ofinguHxi 

 hernia; the integument is invaginated, and !■ 

 thread is introduced as a seton through tin 

 hernia and the inguinal canal. Ashton's, for a cot 



