Image from page 604 of “American practice of surgery ; a complete system of the science and art of surgery” (1906)

Image from page 604 of “American practice of surgery ; a complete system of the science and art of surgery” (1906)
Healing Arts
Identifier: americanpractic07brya
Title: American practice of surgery ; a complete system of the science and art of surgery
Year: 1906 (1900s)
Authors: Bryant, Joseph D. (Joseph Decatur), 1845-1914, ed Buck, Albert H. (Albert Henry), 1842-1922
Subjects: Surgery
Publisher: New York, W. Wood and company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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same sort of flap; the tensor vaginse femoris musclehas been dissected loose and turned upward to fill the canal; the scrotal skinand even the testicle have been invaginated to plug up the canal (measures ABDOMINAL HERNIA. 577 which (oiistitutc in a ((rtaiu a flap method); bono grafts (Weir), spongegrafts, and whv HHgre(> have been inserted to meet the same indications. Inthis category should also be placed the obsolete method of McBurney, whopacked the hernial canal wide open, forcing it to heal by granulation so as todeveloi) a large mass of scai- tissue. These methods all introduce elements ofrisk and inicertainty, and none of them is now largely employed. It remainedfor the method of imbrication of Andrews to supply, in the treatment of inguinalhernia, the step needed to secure the object of all these difficult and ingeniousmethods without in any way adding to the severity of the herniotomy or tothe length of time rocjuired for its performance. This method was published

Text Appearing After Image:
Fig. 215.—The Andrews Operation. Step 1 continued. The skin flaps are held .while the arteryforceps are applied one after the other. (Original.) in 1895 and subsequently by Girard, in Berne, in 1898, and by Professor Fournel,in Paris, in 1900, each writer apparently being unaware of the others work.Lucas-Championniere had still earlier suggested doubling up of the abdominallayers (Fig. 213), as had also Macewen, but this was more by everting than byoverlapping the cut edges, and did not constitute true imbrication. The Andrews Operation for the Cure of Inguinal Hernia.—Two types of imbri-cation or overlapping—a posterior, behind the cord, and an anterior, in front ofthe cord—are described in the original publication (Chicago Medical Recorder,July, 1895). Posterior imbrication appeals to those who like the Bassini method; anteriorimbrication, to those who object to transplanting the cord. Anterior im-brication leaves the cord behind the deep suture line. Of late, the tendencyVO

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