308 • VETERINARY SURGICAL OPERATIONS 



Second Step. — Dissecting the Growth from the Sur- 

 rounding Attachments. — Two curved incisions are made so 

 as to leave them between an elliptical island in whose area 

 all of the orifices or raw tissues, if any exist, are contained 

 The tenaculum or grappling force'p is then hooked into the 

 tumor and given to an assistant who is instructed to lift the 

 tumor up with considerable force. The skin is dissected 

 from the tumor uniformly on all sides until three to four 

 inches of the growth is exposed in every direction ; then an 

 attempt is made to tear the remaining adhesions by grab- 

 bing the tumor in both hands and working the fingers up- 

 ward between it and the skin until the narrowest available 

 part of the cord is reached, near the internal abdominal ring. 

 Spurting vessels encountered are taken up with artery for- 

 ceps and if very large, ligated. When the growth is thus 

 entirely freed from all of its surrounding attachments and 

 now can be freely surrounded with the hands at every part, 

 search here and there is made for bleeding vessels and the 

 flow controlled. 



Third Step. — Ablating the Growth.— The ablation is 

 generally effected with the ecraseur, but when the growth is 

 voluminous at the point of ablation the chain may be 

 deemed unequal to the task and it may be necessary to de- 

 cide in favor of a ligature instead. It is admissible to first 

 attempt to crush it off with the ecraseur, and if develop- 

 ments indicate that this can only be done at the risk of 

 breaking the chain, the cord just below (outward) the level 

 of the chain is transfixed with the needle and thread pre- 

 paratory to ligation. When the thread is in place each 

 half of the cord is tied separately and as tightly as possible. 

 If the cord is very large and there is danger that the first 

 ligature thus applied is insufficient, a second one is applied 

 at the same level so as to cross the first at right angles, thus 

 effecting a quadruple ligation. Before releasing the chain 

 of the ecraseur the cord is cut off with the scalpel about one- 

 half inch from the ligature. 



Fourth Step.— Final Arrest of the Haemorrhage.— De- 

 spite every effort to control bleeding, as the operation pro- 

 ceeds there is always such a copious flow coming from so 

 many directions when the ablation is complete that sys- 

 tematic torsion and ligation would be tedious if not quite 

 impossible. Rather than allow the patient to lose more 

 blood while attempting to control the bleeding with forceps, 

 it is much better to immediately pack the cavity with cotton 

 soaked in mercuric chloride solution 1-500 and then suture 



