Identifier: manualofoperativ1921binn (find matches)
Title: Manual of operative surgery
Year: 1921 (1920s)
Authors: Binnie, John Fairbairn, 1863-1936
Subjects: Surgery, Operative
Publisher: Philadelphia : Blakiston
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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f the sac and reduce it into the spinal canal.Remove the excess of sac. If the nerves lie in the sac wall, empty the sacof its fluid and reduce it en masse after removing all skin from over it. Ifthe case be discovered to be one of meningocele, remove the whole sac aftersuturing its base. Step 4.—Close the wound by a series of deep and superficial sutures. Babcocks Operation.—(Monthly Cyclo. and Med. Bull., May, 1911.) BABCOCK S OPERATION 777 Fasten a blanket firmly between the upright rod legholders on an ordinaryoperating table. Hang the child over this by its groins (Fig. 935) fastening thelegs by bandages to keen it from slipping. In front of the blanket place a hot-water bottle opposite the childs abdomen to prevent chilling. Have an as-sistant at the other side of the blanket to manage the head, watch symptomsand if necessary administer an anesthetic. Sterilize abraded or ulcerated areaswith pure carbolic acid followed by alcohol. Paint the whole area with tinctureof iodine.
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Fig. 935.—(Babcock.) Step I.—Through a fine needle inject into the cephalic part of the sac 3centigrams novocaine or 2 centigrams stovaine, dissolved in 3-^ c.c. sterile 10per cent, alcohol. Inject slowly, withdrawing the piston several times duringthe injection to insure thorough mixing of the analgesic with cerebrospinal fluid.The low specific gravity of the mixture prevents it affecting the higher centresof the cord while the child is inverted, and of course most of it escapes duringthe operation so subsequent danger is averted. Step 2.—If the sac is not too thin dissect away all abraded and ulcerated areasand disinfect again. By transillumination note the position of nerve filamentsand of portions of spinal cord so as to avoid them. Free the skin from the sacand retract the former. Step 3.—Puncture the sac. Resect redundant sac if there is room betweenadherent nerve elements, otherwise let it collapse into the spinal cavity. Witha continuous fine (00 to 000) chromicized ca

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