Surgical therapeutics and operative technique . tion,and which have made it rapid in execution as well as void of danger. First Stage: Incision oe the Integuments.—^It was in 1877 that Iconceived the idea of replacing the U-shaped incision, then recommendedfor thyroidectomy, by a straight transverse incision made over the mostprominent part of the tumour. I first used this incision in the case of ayoung female patient, in order to avoid the disfiguring cicatrix of theU-incision. Ever since that first operation I have employed the followingprocedure without exception: The platysma is divided al
Surgical therapeutics and operative technique . tion,and which have made it rapid in execution as well as void of danger. First Stage: Incision oe the Integuments.—^It was in 1877 that Iconceived the idea of replacing the U-shaped incision, then recommendedfor thyroidectomy, by a straight transverse incision made over the mostprominent part of the tumour. I first used this incision in the case of ayoung female patient, in order to avoid the disfiguring cicatrix of theU-incision. Ever since that first operation I have employed the followingprocedure without exception: The platysma is divided along the wholeextent of the incision, and the superficial veins are retracted by the methodof divulsion. The cutaneous incision is made slightly lateral when thetumour is limited to one of the lateral lobes. Second Stage: Exposure oe the Tumour.^—^^Vhen of small volume,retraction of the subhyoid muscles suffices without division. The medianveins are retracted—if necessary, divided between two ligatures—and the OPERATIONS ON THE NECK 199. Fig. 332.—Thyroidectomy. First and second stages. On the right of the figure is seen the section of the sub-hyoid muscles; on the other side, elevation of the capsule and exposure of thethyroid body.
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