ADRENALECTOMY 155 



a thick layer of muscle and fat before reaching the glands. 

 As already pointed out, the use of spinal anesthesia leads to 

 a more prolonged survival than the use of ether. The objec- 

 tion to the use of spinal anesthesia is the fact that pain im- 

 pulses are still elicited on manipulation of the splanchnics and 

 their associated ganglia. Some authors have recommended 

 the use of nembutal as an anesthetic. 267 Judging from the 

 experimental data on rats the barbiturates should be preferred 

 to ether in adrenalectomy. 



Strict aseptic technique is necessary in adrenalectomy on 

 dogs, cats, and other animals susceptible to infection. The 

 increased susceptibility of the adrenalectomized animal to 

 infection renders strict asepsis more imperative in this opera- 

 tion than in other experimental surgical work. 



The adrenals are extirpated through an incision, 2 to 3 

 inches long, extending slightly ventrally and distally from the 

 angle of the last rib. The lumbar muscle is retracted and the 

 ventral layer of the dorsal fascia exposed and slit, exposing the 

 retroperitoneal tissue behind the kidney. The large vein 

 which runs outward from the midline over the adrenal is dis- 

 sected free, clamped, and followed to the gland. Since the 

 adrenals are fragile, care must be exercised not to grasp the 

 gland. After the gland has been dissected free, the pedicle is 

 ligated and the adrenal removed. Any point of hemorrhage 

 must be carefully ligatured. The wound is closed in the usual 

 manner. 



The most complete study of the survival period of adrenalec- 

 tomized dogs is that of Rogoff and Stewart. 528 In a two-stage 

 operation under ether anesthesia, they found that about two- 

 thirds of their 74 animals lived from 4 to 9 days after the 

 second adrenalectomy. About 10 per cent of the animals lived 

 10 to 12 days while 2 animals survived until the fifteenth day. 

 About one-sixth of the dogs survived less than 5 days. The 

 average survival of all their animals was about 7 days. 



