Operative surgery . on the stretch asit is stripped from thethorax close to the ribsand pectoralis minormuscle. It is well toinclude the delicatesheath of the minormuscle when this ispracticable (Fig. 1339). 8. The lower outerborder of the minormuscle having beenpassed and clearly ex-posed, this muscle is di-vided at right angles toits fibers and at a pointa little below its The tissue, moreor less rich in lymphat-ics and often cancerous,over the minor muscle,near its coracoid inser-tion, is divided as far out as possible, and then reflected inward in order toliberate or prepare for
Operative surgery . on the stretch asit is stripped from thethorax close to the ribsand pectoralis minormuscle. It is well toinclude the delicatesheath of the minormuscle when this ispracticable (Fig. 1339). 8. The lower outerborder of the minormuscle having beenpassed and clearly ex-posed, this muscle is di-vided at right angles toits fibers and at a pointa little below its The tissue, moreor less rich in lymphat-ics and often cancerous,over the minor muscle,near its coracoid inser-tion, is divided as far out as possible, and then reflected inward in order toliberate or prepare for the reflection upward of this part of the minor muscle. 10. The upper outer portion of the minor muscle is drawn upwardwith a broad, sharp retractor (a). This liberates the retractor, which untilnow has been holding back the clavicular portion of the pectoralis majormuscle. 11. The small blood-vessels (chiefly veins) under the minor muscle, nearits insertion, must be separated from the muscle with the greatest Fig. 1237.—Excision of the breast, Halsteds removed en masse. OPKRATIONS (t.\ TIIK TIloifAX. 1011 These jirc imbedded in loose eonnective tissue vvliich seems to be rich inlymplmtics, and contains more or less fat. This fat is often infiltrated withcancer. These blood-vessels should be dissected out very clean and imme-diately ligatod close to the axillary vein. The ligation of these very delicate
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
