SURBERY OP THE INTESTINES 209 



Enterotomy 



Incision of the intestines is performed for the pur- 

 pose of removing foreign bodies or fecal accumu- 

 lation. 



Preparation. — Perform laparotomy, using the same 

 instruments and materials listed and the same tech- 

 nic as for that operation and gastrotomy. 



Technic. — The intestine with the foreign body is 

 located and pulled up in the same manner and with 

 the same precautions as is the stomach in gastrotomy. 



Make an incision and extract the foreign body, 

 clean up the ■ bowel, and suture with Czerny-Lem- 

 bert sutures, taking care to invaginate the edges of 

 the bowel so as to bring the peritoneal surfaces 

 together. 



Enterectomy and Intestinal Anastomosis 



In many cases of injury or gangrene of a portion 

 of the intestines excision of a section of the bowel 

 and anastomosis of the cut ends (enterorrhaphy) is 

 often the only chance of saving the patient's life. 

 To insure any chance of success, the operation must 

 be performed before the onset of peritonitis and 

 utter exhaustion of the patient. 



Preparation. — Perform laparotomy, using the tech- 

 nic for that operation. 



Have ready a scalpel, scissors, twelve No. 8 or No. 

 9 milliner's needles, twelve black sewing silk sutures. 

 No. 2, tied into the eyes of the needles, a needle 

 holder, six ligatures, No. 2 black sewing silk, two 

 pairs of artery forceps, a pair of wire cutters, two 

 hairpins, a piece of rubber sheeting ten inches square 

 with three-inch slit cut in center; gauze, swabs, 

 and so on. ' 



Needless to say, all the above must be perfectly 



