244 Surgical Diseases and Surgery of the Dog 



curs, it must be trimmed, but Znamensky cautions against unneces- 

 sary cutting of it, because there is always more or less hemorrhage 

 therefrom, which finding its way into the interior of the viscus re- 

 tards healing, as pointed out under Cystorraphy. All vessels that 

 have been severed during the operation must be securely ligated. 

 The principal vessels are easily secured as they run under the serosa, 

 prominently in view. Two rows of sero-musculosa — sero-musculosa 

 sutures are advisable. 



VESICO-BECTAL ANASTOMOSIS. CTST0-ENTER0ST0M7. 



It has been demonstrated by Frank that it is possible to under- 

 take this operation with favorable result. This does not seem very 

 remarkable when it is remembered that in early fetal life the renal 

 secretions empty into the primitive cloaca, that this dispositon is 

 normal throughout the life of birds, and that it may occur as a con- 

 genital malformation in the dog (Varaldi). For practical purposes, 

 however, the operation has little application, though, as has been 

 pointed out elsewhere, its employment as a remedial measure for 

 prostatic enlargements in stud dogs in which it is desired to con- 

 serve the testes, is deserving of trial. Frank found that the bladder 

 remained free from feces, that some cases were not followed by 

 ascending infection, and that the presence of urine with feces in 

 the rectum did not produce pathologic irritation of the latter. The 

 feces were always passed in liquid form, being softened by the 

 urine. 



To facilitate the operation Frank used the decalcified bone- 

 coupler devised by himself for anastomosis of all hollow viscera, 

 but the Murphy button would answer the purpose equally as well. 

 The bladder and rectum are emptied of their contents by gentle 

 squeezing and drawn forward into position. Two or three inter- 

 rupted Lembert sutures are applied about half an inch below the 

 lower ends of the incisions determined on in the bladder and rectum, 

 care being exercised in selecting them that the button or coupler, 

 when it is inserted, will not encroach on the ureteral openings in 

 the bladder. A longitudinal incision is then made in the bladder for 

 the coupler and the latter inserted and fixed in position with the 

 puckering string. The rectum is treated in like manner and the two 

 portions of the coupler united. Finally interrupted Lembert sutures 

 are placed around the borders to make the union more secure. 



