76 CESOPHAGOTOMY. 



i8. OSSOPHAGOTOMY. 

 Plate XII. 



Instruments. Razor, scissors, convex scalpel, straight 

 probe-poiuted bistoury, tenaciila, 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, generally somewhat to the left of the 

 median line and gradually deviates farther to the left until 

 toward 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 it. When the oesophagus is 

 empty the operation is best performed in the lower third of 

 the neck at b, Figure i, Plate XII. 



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

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

 mastoido-humeralis mu.scle and the jugular vein. With one 

 finger each of the left and right hand divide the loose con- 

 nective tissue down to the oe.sophagus, which lies between 

 the left scalenus muscle, trachea and the jugular vein. 

 Along the supero-external border of the trachea runs the 

 carotid, accompanied dorsally by the vagus and sympathetic 

 and ventrally by the recurrent nerves. The oesophagus feels 

 like a round mu.scle within which one can feel a firmer cord, 

 the mucous membrane, and has a pale red color. CEsopha- 

 gus and trachea are surrounded by the deep fascia of the 

 neck. Pass one finger around the oesophagus from behind, 

 draw it away from the trachea, force a passage through the 

 deep fascia of the neck and draw the oesophagus out through 

 the external wound. After making an incision through the 

 muscle and mucous membrane introduce a probe pointed 



