The same remark applies to the use of forceps, the jaws of which are so fashioned as to escape pressing on the trachea whilst they grasp directly the foreign body through the walls of the œsophagus.
ŒSOPHAGOTOMY.
Œsophagotomy, or incision of the œsophagus, is an operation which, though sometimes necessary, should only be regarded as a last resort after all other methods have failed. Unfortunately it can be performed only in the region of the neck, and even then the most favourable point (viz., the lower third of the jugular furrow) cannot always be selected, the operation having to be performed directly over the foreign body.
The animal may be either standing or lying down. The seat of operation should be thoroughly cleansed and disinfected.
First stage. Incision through the skin and subcutaneous connective tissue above the level of the jugular vein and opposite the foreign body.
Second stage. Isolation of the œsophagus by dissection and tearing through of the connective and fibro-aponeurotic tissue at the base of the jugular furrow.
Third stage. Incision through the œsophagus for a distance just sufficient to enable the foreign body to be extracted.
Fourth stage. Suturing of the mucous membrane, suturing of the muscular walls of the œsophagus, suturing of the skin, precautions being taken to allow of drainage at the lower part of the operative wound.
SUB-MUCOUS DISSECTION OF THE FOREIGN BODY.
As œsophagotomy, despite every precaution, often leads to fistula formation, Nocard has recommended submucous dissection of the obstructive body, such body being usually semi-solid. This method has considerable advantages.