Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . Fig. 1083.—Operation for Double Goiter.Goiter exposed by transverse incision. Isthmus clamped and divided. 388 SURGICAL TREATMENT ning suture is carried along the edge of the wound (Fig. 1084). The sameoperation is done in the other lobe. The amount of gland tissue to be leftin the two lobes must be determined by the judgment of the surgeon. Itshould be planned that the patient shall be left an amount of thyroid tissuecapable of satisfying the physiologic needs. T

- Image ID: 2AJAF8E
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . Fig. 1083.—Operation for Double Goiter.Goiter exposed by transverse incision. Isthmus clamped and divided. 388 SURGICAL TREATMENT ning suture is carried along the edge of the wound (Fig. 1084). The sameoperation is done in the other lobe. The amount of gland tissue to be leftin the two lobes must be determined by the judgment of the surgeon. Itshould be planned that the patient shall be left an amount of thyroid tissuecapable of satisfying the physiologic needs. T
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Image ID: 2AJAF8E
Surgical treatment; a practical treatise on the therapy of surgical diseases for the use of practitioners and students of surgery . Fig. 1083.—Operation for Double Goiter.Goiter exposed by transverse incision. Isthmus clamped and divided. 388 SURGICAL TREATMENT ning suture is carried along the edge of the wound (Fig. 1084). The sameoperation is done in the other lobe. The amount of gland tissue to be leftin the two lobes must be determined by the judgment of the surgeon. Itshould be planned that the patient shall be left an amount of thyroid tissuecapable of satisfying the physiologic needs. The fact that the gland isdiseased should be taken into consideration, as more diseased gland is re-quired than normal gland. For operating upon extremely vascular goiter with greatly dilated capsularveins, preliminary ligation of the arteries facilitates the procedure. The lowtransverse collar incision is used. It passes through the platysma. Thesternomastoid is retracted strongly outward until the fascia covering thesmall muscles is exposed. This fascia is divided vertically, and the carotidexposed on its inner side. The i

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