ABSTRACT
Today gastrectomy is a routine surgical procedure that any competent surgeon anywhere in the world is expected to perform efficiently, neatly, and well and with, in a reasonably fit patient, a good ninety-five percent chance of a speedy and safe recovery. In January 1881, one of Billroth's favourite assistants, Anton Wölfler, a thirty-year-old Czechoslovakian, called his chief to see a forty-three year-old woman, Thérèse Heller, who had all the symptoms of a malignant pyloric obstruction. Her symptoms dated back to October of the previous year; she was now bedridden and extremely wasted with a thin, rapid pulse, continuous vomiting, and a palpable tumour in the epigastrium. One of the private assistants administered chloroform, and an antiseptic technique was used. Wölfler assisted, and the operating room was heated to twenty degrees centigrade. A transverse incision was made over the tumour which, under the anaesthetic, was found to be movable and the size of a medium apple.
