72 LIGATION OF THE CAROTID ARTERY 



divide the artery midway between them. The second liga- 

 ture is necessary in order to prevent hemorrhage from the 

 distal end through collateral anastomoses and it is essential 

 to sever the artery when permanently ligated, in order to 

 avoid its rupture by the stretching of the undivided carotid, 

 during movements of the neck, where the nutrition has 

 been cut off at the point of ligation. Provide drainage for 

 the wound and suture the muscle and skin. 



19. ESOPHAGOTOMY 

 Fig. 25, 27 



Instruments. Razor, scissors, convex scalpel, straight 

 probe-pointed bistoury, tenacula, artery forceps, absorbent 

 cotton, suture material. 



Technic. The operation can be carried out on the stand- 

 ing or the recumbent animal. At its origin the oesophagus 

 lies above the trachea somewhat to the left of the median 

 line, and as it descends it gradually deviates to the left until 

 in the lower cervical region it lies down along the left side 

 of the trachea. 



The operation is performed at any point between the 

 pharynx and chest where the lodgment of a foreign body or 

 other condition may demand. When the esophagus is 

 «mpty, the practice operation is best performed in the lower 

 third of the neck at b, Fig. 25. 



An incision 10 cm. long through the skin and skin muscle 

 is made on the left side between the anterior border of the 

 mastoido-humeralis muscle and the jugular vein. With the 

 two index fingers divide the loose connective tissue down to 

 the esophagus, which lies between the left scalenus muscle, 

 trachea and jugular vein. Along the supero-external bor- 

 der of the trachea runs the carotid artery, accompanied 

 dorsally by the vagus and sympathetic and ventrally by the 



