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'Mercedes' incision -- another oncoplastic technique for excision of breast tumours.

Ann R Coll Surg Engl 2009; 91: 161–170 168 TECHNIQUE The equipment (Fig. 1) consists of a 10-mm suction-irrigation pipe, Maelecot catheter (no. 30/32), and a small plastic container with air-tight cap. The stone picker (Fig. 2) is prepared as follows. With the help of the hot metal perforator, a small hole of ~3 mm (air vent) diameter is made in the cap of the plastic container. A second hole of ~10 mm diameter is made in the side wall. A small length of Maelecot catheter is used to connect the box to the 10-mm suction-irrigation pipe. The air vent is closed with the right index finger and the system is inserted through the 10-mm (internal diameter) cannula (Fig. 3). Its tip should be placed near the stone to be extracted. The air vent is opened. As the intra-abdominal pressure (10–12 mmHg) is high, there is a gush of air through the cannula which takes the stone out. With this technique, stones less than 10 mm in diameter can be vented out. Larger stones are crushed and then they can be dealt with similarly. This whole set-up can be sterilised 2% glutaraldehyde or in a formalin chamber.