Abstract
The classical operation for preparing an innervated pouch (“Pavlov Pouch”) of a portion of the stomach 1 2 is difficult and time-consuming and there is some doubt whether the pouch retains its full vagus innervation. 3 Modifications have been suggested which were designed to simplify the technic 4 5 or to preserve a larger proportion of the nerve supply. 5 6 1 7 1 8 However, with one exception 8 no procedure has been described which does not involve the complete separation of a part of the wall of the pouch from that of the main stomach with the consequent risk of severance of at least some of the nerve fibers.
The operation to be described leaves intact the entire muscular wall connecting the pouch with the main stomach. This has the double advantage of preserving the entire nerve supply and of avoiding the necessity of severing any of the larger blood vessels. Because no time is lost controlling hemorrhage, the operation can be performed more quickly, and therefore with less shock to the animal than the classical operation. This method exclusively has been used in our laboratory for the past several years with excellent results.
The general plan of the operation involves turning a portion of the stomach inside out through a small incision, thus making the mucosa accessible for the building of a mucosal wall between the projected pouch and the main stomach.
Detailed Procedure. The special instruments required are 2 pairs of vulsellum forceps and a set of gastroenterostomy forceps with 3 blades. The fundic portion of the stomach is delivered through an abdominal incision in the usual manner and the site of the pouch selected. An incision about two centimeters long is made in the center of the pouch area, through the entire gastric wall including the mucosa.
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