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After the separation of adhesions binding down the appendix and ligation and splitting of the meso-appendix, the surgeon comes to the most important steps in appendectomy, namely, the abscission of the appendix and the disposition of the stump. By many operators the mesoappendix and the neck of the appendix are, as is well known, tied wtih strong silk ligatures, cut off and the stump of the appendix is cauterized with pure carbolic acid and invaginated into the coats of the colon by Lembert sutures. Another popular method is that of turning down a cuff of peritoneum, pulling up the other coats, ligating these at the base, abscissing, permitting the musculo-mucous stump to retract and suturing the peritoneal cuff over the stump. This is well known as Barker's method, and is used with slight modifications by Kelly, Deaver and others.
Many surgeons prefer not to ligate the mucous membrane, but simply
EASTMAN JR. IMPROVED TECHNIC OF AMPUTATION AND TREATMENT OF THE STUMP IN APPENDECTOMY. JAMA. 1902;XXXIX(15):893–895. doi:10.1001/jama.1902.52480410017001c
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