CESOPHAGOTOMY. 77 



scalpel or a scissors blade into the lumen of the cesophagus 

 and split its wall. The mucous membrane is wliite and lies 

 in thick lonoitudinal folds. When there is a foreign body 

 in the oesophagus the operation is performed at the point 

 where it is lodged in the manner described and the incision 

 should be made only large enough to permit its removal. In 

 diverticuli of the oesophagus an elliptioal' piece of the mucous 

 membrane which has been overstretched is cut out. The 

 oesophageal wound is closed by a laminated suture, that is, 

 the mucous membrane is united by means of an inte.stinal 

 suture and the mu.scular wall closed ever this. The skin 

 and muscular wound may either be left open or closed with 

 the Bayer suture and bandaged with a drainage tube in the 

 lower angle of the wound. 



