. Operative surgery. tructures. The oesophagoscope is useful, but should be carefully employed. Dilatation is the simplest and safest method of practice in non-malig-nant stricture. Direct and retrograde dilatation are the methods variously formed and sized bougies are utilized for the purpose, andthe finest filiform variety may fail to pass. The size should be increasedfrom time to time, and when directly used, the instrument should be intro-duced in the manner already described (page 665). OPERATIONS ON THE (ESOPHAGUS. 673 The introduction is practiced once in two or three days,
. Operative surgery. tructures. The oesophagoscope is useful, but should be carefully employed. Dilatation is the simplest and safest method of practice in non-malig-nant stricture. Direct and retrograde dilatation are the methods variously formed and sized bougies are utilized for the purpose, andthe finest filiform variety may fail to pass. The size should be increasedfrom time to time, and when directly used, the instrument should be intro-duced in the manner already described (page 665). OPERATIONS ON THE (ESOPHAGUS. 673 The introduction is practiced once in two or three days, according to thecharacteristics of the constriction. The possibility of the presence of aneu-rismal constriction of the tube should be eliminated before an attempt ismade to overcome the obstruction. Retrograde Dilatation.—Retrograde dilatation is directed to the treat-ment of stricture of the lower portion of the oesophagus by way of an open-ing through the stomach (gastrotomy), made as for the removal of foreign. Fig. 852.—Instruments employed in treatment of stricture of the bougie, bulbs of assorted sizes, h. Sandss cesophagotome, bulbs ofassorted sizes, c, d. Bulbous and pointed bougies, e. Bougie with string attach-ment. /. String for friction purposes. Bougies of various materials and of assortedsizes are for sale. bodies, or through the fistula of gastrostomy, as the nature of the case shalldetermine. And in neither instance shotild the opening into the stomachbe so small or so placed as to interfere with ready approach to the cardiac 674 OPERATIVE SURGERY. orifice. Dilatation may be produced by the finger or by any of the stereo-typed urethral or uterine dilators of suitable size and shape; also spongetents, laminaria, and conical metal-capped bougies with string attachmentare utilized for the purpose. Various devices for the primary introductionof a dilating agent are employed. The swallowing of a shot attached to astring (Socin) in advance o
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