Modern surgery, general and operative . uly 29, 1905).—For the last few years I have been performing the operation devised byWilly Meyer. I consider it a most excellent procedure, with distinct points ofsuperiority over other plans. We owe to Gerster the principal of opening theaxilla in the beginning of the operation in order to prevent the diffusion ofcancer cells and so diminish the chance of rapid recurrence. Gersters paperwas published in the Amer. Jour. Med. Sci. in 1888. The younger Gross,in his later years, used to open the axilla first when there was an axillary mass,but he did it in
Modern surgery, general and operative . uly 29, 1905).—For the last few years I have been performing the operation devised byWilly Meyer. I consider it a most excellent procedure, with distinct points ofsuperiority over other plans. We owe to Gerster the principal of opening theaxilla in the beginning of the operation in order to prevent the diffusion ofcancer cells and so diminish the chance of rapid recurrence. Gersters paperwas published in the Amer. Jour. Med. Sci. in 1888. The younger Gross,in his later years, used to open the axilla first when there was an axillary mass,but he did it in order to determine in the beginning of the operation if theaxillary mass was really removable. Willy Meyer emphasizes the value of hisprocedure in lessening hemorrhage. In Meyers operation two flaps are formedby the skin-incision (Fig. 1013)—a lower and an upper flap. The incision forthe formation of the lower flap begins at the point of insertion of the greatpectoral muscle on the humerus, and is carried downward and inward ^ inch. Fig. 1013.—Willy Meyers operation for carcinoma of the breast. Skin incision as practised since 1898- above the border of the muscle and parallel to it. When the incision reachesthe base of the mammary gland, it is carried along the lower margin of the gland,and it ends over the sternum, a little beyond the midline (Fig. 1013). The lowerflap is separated and turned down, a quantity of subcutaneous fat being allowedto remain attached to the breast. This turning down is carried to the borderof the latissimus dorsi muscle, to the axillary cavity, and to the chest then directs that the border of the latissimus dorsi be followed down tothe serratus anticus major, and upward to the mass of fat that enters thebicipital sulcus of the arm. The fat is removed from the anterior border of themuscle by blimt dissection. This anterior lower wound is then packed withgauze. The surgeon next forms the upper flap by uniting the inner and outer endsof
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Keywords: ., bookcentury1900, bookdecade1910, bookpublishe, booksubjectsurgery
