Operative surgery . imary tumors of these struc-tures are comparatively infrequent,the secondary are exceedingly of an innocent nature, andthose limited to the bones and car-tilages, are not, as a rule, difficultto remove; but those of extensivegrowth, especially of a malignant na-ture, present frequently complexproblems and insurmountable obsta-cles to removal for con-sideration. Thoroughasej)tic method andfree exposure of theseat of disease are es-sential elements of thetechnique. A large,oval, musculo - cutane-ous flap, with depend-ent convexity, locatedso as to facilitate obser
Operative surgery . imary tumors of these struc-tures are comparatively infrequent,the secondary are exceedingly of an innocent nature, andthose limited to the bones and car-tilages, are not, as a rule, difficultto remove; but those of extensivegrowth, especially of a malignant na-ture, present frequently complexproblems and insurmountable obsta-cles to removal for con-sideration. Thoroughasej)tic method andfree exposure of theseat of disease are es-sential elements of thetechnique. A large,oval, musculo - cutane-ous flap, with depend-ent convexity, locatedso as to facilitate obser-vation and manipula-tion, should be bone is severed atthe outer limits of in action, showing ^-^^^.^^^ ^ ^^^^ forceps,ntiibiition , and the • ^ or chisel and mallet (Fig. 327), and cau-tiously raised, alongwith the morbid growthfrom tlie body, bymeans of careful dissection. If the growth is malignant, the extent isproblematical, and the possibility of complete removal is uncertain. Exten-. FiG. 1258.—The FcH-ODwm i ,(|the bellows, nsMJiJcd si/(«x dlconductor. An intul).il ion cone ot suitable size is pi-essedinto tiie larynx so as to prevent the escape of air betweenit and the laryngeal wall. The bifurcated ari-angenientof the conductor regulates the amount of air introducedby means of the thumb acting as a valve at the point ofescape. OlKRATlUNS ON THE THORAX. 1033 sive areas of disease involving the sternum, ribs, pleura, and even the peri-cardium, have been successfully removed and tlie patients have important feature of the removal of these growths relates to whether ornot the disease is extrapleural or intrapleural. In the former instances thedanger of ()])erative involvement of the pleural cavity is a matter largelyuiuler the control of the surgeon, wlio, by the employment of judicious fore-thought and cautious technique, will rarely indeed invade this cavity unlessthe pleura itself be involved in the disease. When, however, the
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
