ANASTOMOSIS OF INTESTINE. 



lOI 



fixed in contact, slight inversion of the ends occurring at the 

 sutures. A continuous "double turned" suture {see Fig. 57) 

 was now commenced on the under surface of the bowel about 

 one-third of an inch from the mesenteric attachment ; especial 

 care was paid to the first four stitches to ensure that the knot 

 of the " cone sutures " was buried beneath the line of the con- 

 tinuous suture, the needles here being inserted a little farther 

 from the cut margins. The assistant, holding the bowel at the 



- Vars^- 



Fig. .57. 

 Operation half completed (flog s bowel). 



A.\. Arteries ligatured ; BB. Arterial loops ; c. Gap in mesentery ; i>. Double turn ; 

 E. Cut margins of gut ; GG. Gut. 



apex of each "cone" between the thumb and fingers, kept the 

 cut ends of the gut in view (otherwise excessive inversion 

 occurred during the suturing), and gradually rotated the bowel 

 back to its original position as the suturing proceeded. Especial 

 care must be taken to bury the "cone suture" knots, or peri- 

 tonitis is apt to ensue. As each "double turn" (see Fig. 57) 

 of the continuous suture was in process of being tightened, the 

 assistant, with the closed blades of a pair of scissors applied on 



