84 CESOPHAGOTOMY. 



19. CESOPHAGOTOMY. 

 Pi<ATB XIV. 



Instruments. Razor, scissors, convex scalpel, straight 

 probe-pointed bistoury, tenacula, artery forceps, absorbent 

 cotton, suture material. 



Technic. The operation can be carried out on the 

 standing or the recumbent animal. At its origin the 

 oesophagus lies above the trachea somewhat to the left of 

 the median line and as it descends it gradually deviates 

 farther until in the lower cervical region it lies down along 

 the side. 



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 XIV. 



An incision 10 cm. long through the skin and skin muscle 

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

 mastoido-humeralis muscle and the jugular vein. With the 

 two index fingers divide the loose connective tissue down to 

 the oesophagus, which lies between the left scalenus muscle, 

 trachea and jugular vein. Along the supero-external 

 border of the trachea rnns the carotid, accompanied dorsally 

 by the vagus and sympathetic and ventrally by the re- 

 current nerves. The oesophagus feels like a round muscle 

 within which one can distinguish a firmer cord, the mucous 

 membrane. When brought into view the organ has a pale 

 red color, and it, with the trachea is 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 it out through the external wound. After making an 

 incision through the muscle and mucous membrane intro- 



