814 
LAPAROTOMY. 
bowel coming from the stomach (afferent portion) is immediately 
recognised by its being distended, and should be kept closed by an 
assistant pinching it. The bowel is now incised immediately over the 
foreign body, and in its long axis, as far as seems necessary. After 
taking away the foreign body, the wound in the abdominal wall is closed. 
At this time it is important to keep the afferent portion of bowel closed 
to prevent advancing ingesta soiling the wound, and, in case of need, a 
provisional ligature may even be applied, but must not be drawn very 
tight. It can be replaced by a twisted strip of sterilised gauze applied 
with moderate tension around both the afferent and efferent portions of 
bowel. To soak up discharge a thick mass of sterilised gauze may be 
loosely applied around the bowel on the inner side of each of these 
ligatures. Finally the intestinal wound is closed with bowel sutures 
(figs. 186 to 188). As it is very important to bring the serosa of both 
sides into contact, and to make the closure as perfect as possible 
without piercing all the intestinal coats, which would perhaps lead to 
peritonitis, one of the methods recommended by Gely, Lembert, or 
Wolfler may be employed. Thereafter the surface of the intestine and 
of the wound is once more cleansed, the abdominal muscles and skin are 
sutured with sterilised material, and a proper dressing applied. Where 
the animal is particularly valuable continuous watching may be necessary 
to prevent the dressing moving or being torn off. A dog operated on by 
Moller, pulled off the dressing and loosened the sutures, occasioning 
prolapse of the bowel and death. 
In the horse laparotomy has often been successfully performed for the 
castration of cryptorchids, and McQueen, in a paper on “ Abdominal 
Surgery” read before the National Veterinary Association in 1895, 
gives a long series of cases in which accidental wounds penetrating the 
peritoneal cavity, and with or without prolapse of abdominal organs, have 
been successfully treated. He himself surgically opened the peritoneal 
cavity in four experimental cases. In three he withdrew and handled 
portions of intestine, incised the floating colon, and closed the wound 
with sutures. In the fourth he divided and afterwards united the 
jejeunum. The first case died of septic pneumonia; the two succeeding 
cases recovered, but for research purposes were afterwards killed. The 
last case died in 89 hours. 
In practice, Dollar, Rickards, and Rogers unsuccessfully resected a 
portion of floating colon. Smith and Garry have also performed laparo- 
enterotomy for obstructed bowel, but the horses died. Felizet in 1849 
is said to have cured a miller’s horse in France by removing a calculus 
through a flank incision, but no such successes have been reported in 
England. Where operation has been attempted it has usually been 
postponed until too late. The success of treatment of accidental 
