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December 3, 1904


JAMA. 1904;XLIII(23):1701. doi:10.1001/jama.1904.02500230031003

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Since the operation of valvotomy has been established as a means of relief from obstinate constipation or obstipation, the tendency has been to simplify the armamentarium and the operative procedure.

I have devised an instrument in the form of a clip, which painlessly divides the muscular fibers contained in the rectal valve in from three to five days without fear of hemorrhage or peritonitis. Figure 1 represents the applicator with clip in its grasp, opened, ready for application to the hypertrophied valve. The clips are made in three sizes, short, medium and long. Each consists of two fenestrated elliptical jaws controlled by a set-screw (Fig. 2). The apposing surfaces have a slightly elevated serration in their center running from the base of one side around the tip to the opposite side. This represents the cutting surface. On the outer side of the serration is a narrow, smooth surface that makes

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