i86 Surgical Diseases and Surgery of the Dog 



intussusception. Frank examined specimens of anastomosed bowel 

 and observed that no true regeneration of the muscular coat had 

 taken place. There had been some proliferation of muscle cells 

 and an attempt to regenerate but fibrous connective tissue had 

 filled up the interspaces like a weed, crowding out the more delicate 

 structures. 



In the lateral operation each cut end is first closed by in- 

 vaginating its margins and suturing with continuous suture. By 

 incision, an opening is then made in the wall at the greater cur- 

 vature, about two inches from each closed end. Senn claims that the 

 lateral operation is particularly advantageous in that the point of 

 contact is always made on the convex surface, so that the means 

 employed to secure coaptation do not interfere with the blood supply 

 from the mesenteric vessels, and that it requires much less time 

 than end-to-end enterorraphy. The openings are brought into ap- 

 position by inter-suturing of their respective margins, or by employ- 

 ment of any of the devices used for the purpose, as in the end-to- 

 end operation, and are thus made to form the intercommunicating 

 channel between proximal and distal portions of the bowel. Pas- 

 sage of bowel contents is also by mechanical pressure from above, 

 but there is less liability to intussusception. 



A great many devices have been contrived to facilitate anas- 

 tomosis. Some of them are merely intended to assist in holding 

 the cut ends in apposition while sutures are being applied, and take 

 no further part in afifecting the reunion. Others allow the operator 

 to dispose with all or most of the suturing, but must necessarily 

 remain in position, holding the cut ends in apposition sufficiently 

 long for reunion to be established. Some of the latter, particularly 

 those which are unabsorbable, like the Murphy button, hold the 

 ends together by compression, thus producing more or less gangrene. 

 This feature of pressure-gangrene production constitutes . a pro- 

 nounced defect, and all mechanical devices depending upon it for 

 the desired effect are necessarily active irritants and a menace to 

 the reparative capacity of the parts. In fact, the best method 

 must be that which dispenses altogether with the presence of any 

 foreign body, except it be to lend temporary support to the parts 

 during suturing. 



But without the employment of some kind of supporting de- 

 vice, the operation is rendered vastly more difficult. When the in- 



