File:Transactions of the Southern Surgical and Gynecological Association (1910) (14582037909).jpg

Identifier: transactionsofso2319sout (find matches)
Title: Transactions of the Southern Surgical and Gynecological Association
Year: 1910 (1910s)
Authors: Southern Surgical and Gynecological Association (U.S.)
Subjects: Surgery Gynecology Surgery Genital Diseases, Female
Publisher: (S.l.) : The Association
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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hage, and relieves the trachea of pressurefrom the weight of the tumor. The vessels can now be clamped as the elevated goitrelifts them away from the surface of the capsule (Figs. 10and 11). The capsule adherent to the posterior structures isthus separated from the vessels and there is no danger of thenerve being included with the vessels or any danger ofinjuring the parathyroids. Occasionally when the enlargedlobe extends high up in the neck, it is better to place asecond small volsellum forceps on the upper part and maketraction upward and downward to better expose the superiorthyroid artery and vein. This constant upward traction on the tumor allows it tobe rapidly dissected from the posterior structures and onlyheld by the isthmus of the gland. A large clamp crushesthis part, which can be sutured over. The capsule, muscles, and skin are now closed in theusual way and drainage provided through a stab wound inthe lower flap. This technique differs from that of others in that it does
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ig. 1.—Goitre before the operation. Fig. 4.—Elevating the skin and separating with the ig. 2.—Prepared for the operation. scissors as a dissector. ig. 3.—Making the incision with the scissors. Fig. 5.—Cutting the skin and the platysma. Fig. 6.—Sternomastoid and sternohyoid muscles exposed.

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