

OPERATIONS 



made with a concave knife. 2. For ectropion : detach- 

 ment of the everted lid, except at the angles, and its 

 adaptation to the eyeball. 3. For ectropion of the up- 

 per lid ; the incision is made parallel to the edge of 

 the lid, with excision of a portion equal to the differ- 

 ence in the lengths of the lids ; the wound is then 

 sutured. 4. For entropion ; excision of a portion of 

 the lid with the cilia and hair-bulbs, and healing by 

 granulation. 5. For excision of the elbow ; a modifi- 

 cation of Moreaiis incision, in which the outer verti- 

 cal limb of the H is omitted. 6. For excision of the 

 excision through an opening made in the 

 cheek by a curved incision extending from the angle 

 of the mouth to the anterior edge of the masseter 

 muscle. 7. For trichiasis ; paring away of the edge 

 of the lid ; removal of the portion of skin over the 

 hair-bulbs. Jaesche's : I. For Jistichiasis ; the mar- 

 gin of the lid is separated except at either end ; an 

 incision is made parallel to this, and the intermediate 

 portion of skin is removed ; the wound is then closed 

 with sutures. SeeArlt's Operation. 2. Plastic; the 

 triangular gap is closed by displacing and transplant- 

 ing a flap marked out by a curved lateral incision, and 

 sutures are applied. Janin's, for iridotomy ; a vertical 

 incision of the iris is made on the inner side of the pupil 

 by a knife or scissors introduced through the cornea. 

 Jeffray's, for excision of the knee ; it is done by two 

 vertical lateral incisions. Jenks', for lacerated peri- 

 neum ; denudation of the surface by means of scissors 

 ntroduced at the lower edge, close to the integument, 

 ind made to dissect up the lower surface without being 

 ■vithdrawn. Jobert's (J/. ): I. For castration; a curved 

 incision is made upon the scrotum, with its convexity 

 turned downward and inward. 2. For ligation of the 

 •upper part of the popliteal artery; an incision, three 

 mches in length, is made parallel with and just pos- 

 terior to the tendon of the adductor magnus muscle, 

 pommencing at the junction of the middle with the 

 ower third of the thigh. 3. For the radical cure of 

 hernia : two cannulated needles are passed and the 

 rannute allowed to remain until the requisite amount of 

 nflammation has been produced. 4. For suture of 

 he intestim ; the invagination method ; the upper 

 egment is transfixed near the divided margin on two 

 pposite sides by a needle and thread ; the two ends 

 f the thread hanging down on each side are both 

 rmed with needles, and, the intestinal wall of the 

 .ower segment being transfixed, the invagination is 

 i ampleted. partly by traction on the sutures, and partly 

 .y squeezing. Jones' (P.), for lumbar colotomy ; a 

 loditication of Bryant's operation in which the 

 >wer end of the colon is closed by detaching the 

 .ucosa from the upper segment of the bowel and 

 g it by sutures. Jones' (S.), a method of 

 erforming gastrostomy ; the parietal incision is made 

 ; most in a vertical direction, in a line drawn from the 

 tt nipple to the spine of the pubes. Jones' ( IV.), 

 r ectropion : a V-shaped incision is made with its 

 :>ex directed away from the margin of the lid ; when 

 united with sutures, after the skin has been 

 ieed from the underlying tissues, the wound is Y- 

 aped. Jordan's, for resection of the nose for removal 

 polypi : osteoplastic resection of the nose and split- 

 ■ ? ot the upper lip to give more room. Jordan's 

 1. For amputation at the hip-joint; 

 parts are divided down to the bone by the 

 cular method, as low down as possible, and the 

 Tiur is shelled out by a longitudinal incision along 

 - outer side of the thigh. 2. For amputation at the 

 'oint ; the soft parts are divided down to the 

 ne by the circular method, three or four inches below 

 axilla, and the humerus is shelled out by a longi- 



II 



913 OPERATIONS 



tudinal incision along the outer and posterior aspect 

 of the limb, meeting the circular incision at right 

 angles. 3. For excision of the tongue ; division of the 

 cheek back to the ramus of the jaw, and removal of 

 the diseased part by two ecraseurs, worked simultane- 

 ously. The same as Jaeger's operation. 4. For removal 

 of a tumor of the naso-pkarynx ; an incision begin- 

 ning at the gingivo-labial fold, just below the posterior 

 margin of the nostril, is carried forward into the nasal 

 cavity, on through the ala of the nose, and along 

 the lateral aspect of the nose ; the whole upper lip is 

 then divided, the flaps turned aside, and the anterior 

 nares exposed. Jdrg's, for otherwise impossible labor. 

 See Laparo-elylrotomy . Jurine's, for iridotomy ; the 

 needle is introduced through the sclerotic, and the 

 iris is punctured from behind forward, and from 

 before backward, and the punctures are united by 

 an incision. Kappelers, for choLcystenterostomy ; 

 it is performed in one stage ; the distended gall- 

 bladder is emptied by puncture with a trocar, and 

 the margins of the wound, after being enlarged, are 

 united, by means of a double row of sutures, to the 

 highest part of the jejunum. Keegan's, a method of 

 rhinoplasty ; the Indian method ; the flap being de- 

 rived mainly from one' side of the forehead. Keen's 

 ( V V. II'.): 1. For linear craniotomy; the skull is 

 exposed through a slight flap, and the bone is divided 

 by means of a special bone-cutting forceps. 2. P'or 

 prominent auricles ; a large oval piece of skin is re- 

 moved from the back of the ear, and a V-shaped piece 

 of cartilage is excised. 3. For stretching the facial 

 nerve ; the use of a weak faradic current to find the 

 nerve, and stretching from the periphery toward the 

 center ; the remainder of the operation is the same as 

 Bauni 1 s operation. Keetley's (C. B.), for the radical 

 cure of umbilical hernia ; after separation and torsion of 

 the sac, it is drawn, by means of a ligature, into a pre- 

 pared space between the linea alba and the peritoneum, 

 above the umbilical ring. Kehrer's : I. A method of 

 performing Cesarean section ; a modification of the usual 

 operation, in which the uterus is opened at the level 

 of the internal os by a transverse incision. 2. For 

 depressed nipple ; excision of a ring of skin around 

 the nipple, and healing by granulation. Keith's : 



1 . A method of performing hysterectomy for myoma ; 

 either enucleation, or removal of the entire organ and 

 its appendages, with the clamp- treatment of the pedicle. 

 2 A method of performing ovariotomy ; treatment of 

 the pedicle with the cautery and clamp. Kelly's {H. 

 A.), for retro-positions of the uterus ; median celiotomy, 

 followed by stitching of the uterus to the ventral abdomi- 

 nal wall. Kelsey's, for inguinal colotomy ; the incision 

 is parallel to and half an inch above Poupart's ligament. 

 Kerr's, for amputation at the hip-joint ; the same as 

 Pavatoris amputation. Kessel's: I. F or establishing 

 a permanent perforation in the ear-drum; it consists 

 in the removal of the tendinous ring that attaches the 

 drum -membrane to the bone, and in chiseling away a 

 portion of this bone along the posterior circumference. 



2. For the mobilization of the stapes, in chronic non- 

 suppurative middle-ear inflammation ; it consists in 

 separating the inflammatory adhesions. Key's, for 

 lithotomy ; the lateral operation with the straight staff. 

 See Lithotomy. Keyes' (£. L.), for varicocele ; sub- 

 cutaneous ligation with a special needle, carrying two 

 silk ligatures ; it is best performed in the standing 

 position under the use of cocain. Kinloch's, for in- 

 ternal urethrotomy ; it is done with a special urethro- 

 tome used to divide the stricture from within outward. 

 Klineberger's, for lumbar nephrectomy ; a curved in- 

 cision is made with its convexity upward and outward. 

 Knapp's (//.): I. For blepharoplasty ; the formation 



