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The Surgical Removal of the Gizzard from the Domestic Fowl
T h e Surgical Removal of the Gizzard from the Domestic Fowl W.
H.
BURROWS
(Received for publication September 25, 1935)
D
URING the course of some studies of the physiology of poultry nutrition, it became desirable to study the functions of the gizzard by the indirect method of extirpation. Inasmuch as a search of the literature failed to disclose a technic for the surgical removal of the gizzard from the domestic fowl, the author presents the following technic which has been used successfully at Beltsville Research Center during the last two years. The preparations have been used by Burrows, Fritz, and Titus (1935) in a study of the blood sugar level, as affected by the gizzard, and by Fritz, Burrows, and Titus (193S) in a comparison of digestibility in gizzardectomized and normal fowl. T H E TECHNIC
The bird is fasted 48 hours and prepared for operation in the usual manner. Anesthesia is applied and when the feathers become loosened, as they do under general anesthesia, the area in which the incision is to be made is plucked. The bird is then restrained on its right side with the right leg extended behind it and the left leg retracted far forward, exposing the abdomen which is then iodinized over the left surface and draped with towels. An incision is made in the abdomen from the left external notch, posteriorly, midway between the xyphoid process and the os pubis to within about 2 cm. of the anus. One small bleeder is usually encountered, bisecting the line of incision about midway
in its course. The vessel is superficial and in most cases can be seen through the skin before the incision is made. It must be picked up with a hemostat and ligated or a considerable hemorrhage will occur. If the incision is not extended too far posteriorly, there will be no other bleeding that cannot be stopped readily by simple application of a sponge. The gizzard will be found with its dorsal outline just within the incision. An apronlike ligament holds the anterior surface of the gizzard to the ventral wall of the abdomen. The gizzard is freed from this ligament by dissection with small curved scissors, after which the gizzard swings freely from the proventriculus and duodenum. It can now be lifted out through the incision and placed as shown in Figure 1. The blood supply to the gizzard is now ligated. Branches of the arteria hepatica dextra extend from the dorsal extreme and spread, with many further branches, over the surface of the gizzard. These can be grouped together with their accompanying veins and mass-ligated at two points, after which the vessels are cut between ligatures. The ligature on the peripheral side of the cut is shown in Figure 1. Another vessel, a branch of the recurrent sinister, is found bridging the ventral surface from the proventriculus to the gizzard. This also is doubly ligated and cut between ligatures. Kelly forceps are now placed, two on the proventriculus and two on the duo-
[290]
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
National Agricultural Research Center, Beltsville, Maryland
JULY,
193
6.
VOL.
XV,
No.
291
4
the duodenum is undoubtedly the most difficult part of the technic. The proventriculus can be retracted posteriorly barely enough to allow suturing and the difference in circumference of the two segments renders it all but impossible to construct a patent anastomosis. To offset the disadvantage of the strong tendency of the proventriculus to retract
FIG. 1. The gizzard exposed with Kelly forceps in place on the proventriculus and duodenum.
To make the anastomosis of these small and unequal segments of the gastrointestinal tract, the cut ends must be released and allowed to open. A small amount of bile and gastric juices usually escapes and drips on the moist pack. However, if the bird had been fasted 48 hours and without water over night, there will be but little material to drain. No attempt is made to change the pack because of this soiling and no case of peritonitis has been observed as the result of working over the soiled pack. The anastomosis of the proventriculus to
anteriorly, the proventriculus and the duodenum are brought together with stay sutures, placed about one-third of the circumference apart in the under edges of the segment. These sutures are retracted laterally and posteriorly by an assistant and the first part of the anastomosis is formed from the inside of the bowel with a continuous suture, using a glovers' stitch. The suturing is begun at the stay suture nearest the operating surgeon and proceeds away from him. When the suture line mounts the far side of the segments and begins to work
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
denum, as shown in Figure 1 and a moist, gauze pack is drawn through the hiatus between the gizzard and the other viscera. The proventriculus and duodenum are transsected between the forceps with a sharp scalpel. The gizzard is removed and the cut ends of the proventriculus and duodenum are brought together over the moist pack.
292
SCIENCE
to 72 hours after operation and then should be fed cautiously for a few days so that they will be unable to fill their crops at any one feeding. Only finely ground feed should be given at any time. Water may be safely given the day following operation. Causes of mortality have been found to be feeding too soon after operation, impaction of the proventriculus from feeding
Fio. 2. Anastomosis of the proventriculus and duodenum. (Retouched to make the sutures stand out.)
in the circumference of the two segments. The incision is closed in three layers: peritoneum, muscle and fascia, and the skin. Size 0 pure silk sewing thread is used throughout for suturine material. For making the anastomosis, a Hagedorn's intestinal needle size 19 was found most satisfactory. POST-OPERATIVE TREATMENT AND SURVIVAL
Birds from which the gizzards have been removed should not have any feed for 48
particles that were too large and inability of the birds to stand the operation. Birds about three quarters grown have been found to be best able to survive the operation. Birds making a successful recovery may continue in good health indefinitely. A Rhode Island Red male, gizzardectomized April, 1933, still appears and acts normal, and a hen, gizzardectomized November, 1934, lays normal eggs and gives no external indication of being abnormal. From a total of 24 operations, 11 were successful
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
back over the top toward the operator, tne suture is brought to the outside of the bowel, using the Connell stitch. A second line of inverting suture cannot be used without almost certainly causing an obstruction of the bowel. The finished anastomosis is shown in Figure 2. An oblique cut through the duodenum does much to compensate for the difference
POULTRY
JULY,
1936.
VOL.
XV,
No.
293
4
and 13 failed. Seven of these failures were caused by rupture of the anastomosis, due to feeding too soon after the operation, two from unknown causes, three from impaction of the proventriculus with coarse feed and one from surgical occlusion of the bowel. SUMMARY
REFERENCES
Burrows, W. H., J. C. Fritz and H. W. Titus, 193S. The Blood Sugar of the Fasting, Gizzardectomized Fowl Jour, of Biol. Chem. 110:39. Fritz, J. C , W. H. Burrows and H. W. Titus, 1935. A comparison of Digestibility in Gizzardectomized and normal fowls. Poultry Science IS :239243.
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
A technic for the surgical removal of the gizzard from the domestic fowl is described.
The post-operative treatment and survival is discussed and reference is made to studies in which the preparation has been used.
H.
BURROWS
(Received for publication September 25, 1935)
D
URING the course of some studies of the physiology of poultry nutrition, it became desirable to study the functions of the gizzard by the indirect method of extirpation. Inasmuch as a search of the literature failed to disclose a technic for the surgical removal of the gizzard from the domestic fowl, the author presents the following technic which has been used successfully at Beltsville Research Center during the last two years. The preparations have been used by Burrows, Fritz, and Titus (1935) in a study of the blood sugar level, as affected by the gizzard, and by Fritz, Burrows, and Titus (193S) in a comparison of digestibility in gizzardectomized and normal fowl. T H E TECHNIC
The bird is fasted 48 hours and prepared for operation in the usual manner. Anesthesia is applied and when the feathers become loosened, as they do under general anesthesia, the area in which the incision is to be made is plucked. The bird is then restrained on its right side with the right leg extended behind it and the left leg retracted far forward, exposing the abdomen which is then iodinized over the left surface and draped with towels. An incision is made in the abdomen from the left external notch, posteriorly, midway between the xyphoid process and the os pubis to within about 2 cm. of the anus. One small bleeder is usually encountered, bisecting the line of incision about midway
in its course. The vessel is superficial and in most cases can be seen through the skin before the incision is made. It must be picked up with a hemostat and ligated or a considerable hemorrhage will occur. If the incision is not extended too far posteriorly, there will be no other bleeding that cannot be stopped readily by simple application of a sponge. The gizzard will be found with its dorsal outline just within the incision. An apronlike ligament holds the anterior surface of the gizzard to the ventral wall of the abdomen. The gizzard is freed from this ligament by dissection with small curved scissors, after which the gizzard swings freely from the proventriculus and duodenum. It can now be lifted out through the incision and placed as shown in Figure 1. The blood supply to the gizzard is now ligated. Branches of the arteria hepatica dextra extend from the dorsal extreme and spread, with many further branches, over the surface of the gizzard. These can be grouped together with their accompanying veins and mass-ligated at two points, after which the vessels are cut between ligatures. The ligature on the peripheral side of the cut is shown in Figure 1. Another vessel, a branch of the recurrent sinister, is found bridging the ventral surface from the proventriculus to the gizzard. This also is doubly ligated and cut between ligatures. Kelly forceps are now placed, two on the proventriculus and two on the duo-
[290]
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
National Agricultural Research Center, Beltsville, Maryland
JULY,
193
6.
VOL.
XV,
No.
291
4
the duodenum is undoubtedly the most difficult part of the technic. The proventriculus can be retracted posteriorly barely enough to allow suturing and the difference in circumference of the two segments renders it all but impossible to construct a patent anastomosis. To offset the disadvantage of the strong tendency of the proventriculus to retract
FIG. 1. The gizzard exposed with Kelly forceps in place on the proventriculus and duodenum.
To make the anastomosis of these small and unequal segments of the gastrointestinal tract, the cut ends must be released and allowed to open. A small amount of bile and gastric juices usually escapes and drips on the moist pack. However, if the bird had been fasted 48 hours and without water over night, there will be but little material to drain. No attempt is made to change the pack because of this soiling and no case of peritonitis has been observed as the result of working over the soiled pack. The anastomosis of the proventriculus to
anteriorly, the proventriculus and the duodenum are brought together with stay sutures, placed about one-third of the circumference apart in the under edges of the segment. These sutures are retracted laterally and posteriorly by an assistant and the first part of the anastomosis is formed from the inside of the bowel with a continuous suture, using a glovers' stitch. The suturing is begun at the stay suture nearest the operating surgeon and proceeds away from him. When the suture line mounts the far side of the segments and begins to work
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
denum, as shown in Figure 1 and a moist, gauze pack is drawn through the hiatus between the gizzard and the other viscera. The proventriculus and duodenum are transsected between the forceps with a sharp scalpel. The gizzard is removed and the cut ends of the proventriculus and duodenum are brought together over the moist pack.
292
SCIENCE
to 72 hours after operation and then should be fed cautiously for a few days so that they will be unable to fill their crops at any one feeding. Only finely ground feed should be given at any time. Water may be safely given the day following operation. Causes of mortality have been found to be feeding too soon after operation, impaction of the proventriculus from feeding
Fio. 2. Anastomosis of the proventriculus and duodenum. (Retouched to make the sutures stand out.)
in the circumference of the two segments. The incision is closed in three layers: peritoneum, muscle and fascia, and the skin. Size 0 pure silk sewing thread is used throughout for suturine material. For making the anastomosis, a Hagedorn's intestinal needle size 19 was found most satisfactory. POST-OPERATIVE TREATMENT AND SURVIVAL
Birds from which the gizzards have been removed should not have any feed for 48
particles that were too large and inability of the birds to stand the operation. Birds about three quarters grown have been found to be best able to survive the operation. Birds making a successful recovery may continue in good health indefinitely. A Rhode Island Red male, gizzardectomized April, 1933, still appears and acts normal, and a hen, gizzardectomized November, 1934, lays normal eggs and gives no external indication of being abnormal. From a total of 24 operations, 11 were successful
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
back over the top toward the operator, tne suture is brought to the outside of the bowel, using the Connell stitch. A second line of inverting suture cannot be used without almost certainly causing an obstruction of the bowel. The finished anastomosis is shown in Figure 2. An oblique cut through the duodenum does much to compensate for the difference
POULTRY
JULY,
1936.
VOL.
XV,
No.
293
4
and 13 failed. Seven of these failures were caused by rupture of the anastomosis, due to feeding too soon after the operation, two from unknown causes, three from impaction of the proventriculus with coarse feed and one from surgical occlusion of the bowel. SUMMARY
REFERENCES
Burrows, W. H., J. C. Fritz and H. W. Titus, 193S. The Blood Sugar of the Fasting, Gizzardectomized Fowl Jour, of Biol. Chem. 110:39. Fritz, J. C , W. H. Burrows and H. W. Titus, 1935. A comparison of Digestibility in Gizzardectomized and normal fowls. Poultry Science IS :239243.
Downloaded from http://ps.oxfordjournals.org/ at National Institute of Education Library, Serials Unit on May 27, 2015
A technic for the surgical removal of the gizzard from the domestic fowl is described.
The post-operative treatment and survival is discussed and reference is made to studies in which the preparation has been used.