JAMA. 1906;XLVII(1):37. doi:10.1001/jama.1906.25210010037002b.
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While it is impossible in all cases to adhere to an ideal technic in appendicectomy, it is generally admitted that where it is practicable invagination of the stump is desirable. In many instances, however, especially when the purse-string suture is placed too far from the junction of the cecum and appendix, the stump is not invaginated, but simply covered up with the peritoneum in the grasp of a suture applied in such a manner.

As performed, the invagination is usually accomplished with an ordinary pair of tissue or hemostatic forceps, which serve satisfactorily so far as invagination is concerned, but on drawing the purse-string suture taut, release of the forceps often becomes awkward, and sometimes difficult. Frequently the invagination is undone when the forceps are being withdrawn, owing to the increased pressure exerted on the appendiceal tissue within their grasp by the tension of the purse-string suture on the forcep


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