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February 15, 1913


JAMA. 1913;60(7):511-512. doi:10.1001/jama.1913.04340070023008

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For years I have performed gastro-enterostomies in a manner that permits the position and direction of the incision in both stomach and bowel to be accurately located. I have felt that this is not always accomplished, as the operation is ordinarily performed, because a relatively large amount of each viscus is drawn up between the jaws of the Moynihan clamp before the sutures are placed.

In performing a gastro-enterostomy, there is an anatomic status which should be obtained—a status which William J. Mayo considers most satisfactory—namely, the establishment of an opening starting about the middle of the posterior wall of the stomach and running obliquely downward and to the left, as shown in Figure 1.

After the abdomen has been opened I expose the highest part of the jejunum, without altering its normal direction, as it passes out from under the peritoneum. Two guide sutures are then placed in the

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