. Modern surgery, general and operative. nthen be more easily and rapidly cleared. The re-moval of the muscle does not impair arm move-ments, and its retention leads to the formation,when healing is complete, of a cord-like band infront of the axilla. (See Douglas Drew, in Jour., May 17, 1902,) The smah blood-vessels under the minor muscle are carefully sepa-rated from it, are dissected out very clear, and areligated close to the axillary vessels. Having ex-posed the subclavian vein at the highest possiblepoint below the clavicle, the contents of the axilla aredissected away with a s
. Modern surgery, general and operative. nthen be more easily and rapidly cleared. The re-moval of the muscle does not impair arm move-ments, and its retention leads to the formation,when healing is complete, of a cord-like band infront of the axilla. (See Douglas Drew, in Jour., May 17, 1902,) The smah blood-vessels under the minor muscle are carefully sepa-rated from it, are dissected out very clear, and areligated close to the axillary vessels. Having ex-posed the subclavian vein at the highest possiblepoint below the clavicle, the contents of the axilla aredissected away with a sharp knife and the vein and its branches are strippedabsolutely clean. The loose tissue about the artery and the nerves should alsobe removed. When the vessels are cleared, the axillary contents are rapidlystripped from the inner walls of the axilla and the lateral wall of the thorax(Fig. 1093). The fascia which binds the mass to the chest is cut loose from theribs and the serratus magnus muscle. Just before reaching the junction of the. Fig. 1094.—The youngerSenns incision for amputa-tion of the breast. Halsteds Operation for Carcinoma of the Mammary Gland 1591 posterior and lateral walls of the axilla an assistant draws the triangular flapof skin outward in order to spread out the tissue which lies upon the subscapu-laris, teres major, and latissimus dorsi muscles. The operator cleans the pos-terior wall of the axilla from within outward. The subscapular vessels areclearly exposed, and are caught before they are cut. In some cases the sub-scapular nerves are removed, in others they are permitted to remain. Havingpassed these nerves, the mass is turned back into its normal position and severed
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