March 20, 1915

Exposure of Appendix by Cullen's Method

Author Affiliations

Columbus, Ohio.

JAMA. 1915;LXIV(12):1017. doi:10.1001/jama.1915.02570380065036

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To the Editor:  —The article on this subject by Neill (The Journal, Jan. 23, 1915, p. 299) was read with much interest by myself and assistants, but none of us could see what advantage there was in the use of the tapes, while we could see many disadvantages, particularly in the loss of time.I have operated on many retrocecal appendixes; have had at least a half dozen since this article appeared. Such appendixes are usually more or less adherent, and many of them are in different stages of gangrene. They can usually be found readily by palpation, by following the wide band, or by locating the junction of the cecum and ileum. The cecum being supported, or in some cases the cecal end of the appendix caught with a hemostat, the surgeon can palpate the deep-seated appendix, and readily accomplish its removal. Its enucleation usually takes about one minute.

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