Intra-thoracic surgery : bronchotomy through the chest-wall for foreign bodies impacted in the bronchi / by De Forest Willard.

  • Willard, De Forest, 1846-1910.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Intra-thoracic surgery : bronchotomy through the chest-wall for foreign bodies impacted in the bronchi / by De Forest Willard. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the bronchus cleared from the surrounding vessels and incised for one half inch. Very free hemorrhage occurred from wound of the pulmonary vein. This was controlled by hsemostatic forceps, and afterward by chromicized catgut ligatures above and below the wound. The opening in the bronchus was then stitched with chromicized cat- gut, the gut being threaded upon a small, sharply curved needle. Three interrupted sutures were thus inserted and tied. The chest cavity was cleared of blood. The incision in the chest was then thoroughly sponged and rendered as clean as possible. The deep muscles were drawn together by sutures and superficial stitches added. The dog rallied well, and on the following day ate and drank. Two days later, however, he died. Cause unknown, as through an error I was not notified until after he had been buried, consequently the post-mortem examination was lost. Experiment IV. Thoracotorny; excision of ribs; bronchotomy ; ptmcfure of pulmonary vein.—Liver and white colored male dog; weight, forty pounds. Etherized, shaved, etc. Incision on the left side in the mid-lateral region between the third and fourth ribs. Four inches of the fourth rib resected periosteally without opening the chest. The pleura was then incised and the upper lobe drawn out. As the dyspnoea in the former case was greatly relieved when the wound in the chest was closed or rendered smaller, an attempt was made to prevent the great inrush of air by drawing out the lobe of the lung and passing it through a slit in a sheet of rubber-dam, thus making an impervious veil and assisting in the relief of air- pressure. The dam was pushed back until the bronchus of this lobe was exposed outside of the slit. The bronchus was bare of pulmonary vessels, and was quickly and easily incised without injuiy to them. The amount of collapse was less than in the former case, possibly because the left side was being operated upon, and the weight of the heart did not press so heavily upon the left lung, as the heart was in the reverse position. The dog suffered but little from air-hunger. One stitch was easily placed with a curved staphylorrhaphy needle, and matters looked favorable for a speedy and safe completion of the operation, as the dog was doing well. In placing the second stitch, however, a sudden movement of the root of the lung caused the point of the needle to enter the pulmonary vein, and a gush of blood ensued. This was conducted from the chest by the rubber-dam trough,