On the origin and progress of renal surgery : with special reference to stone in the kidney and ureter and to the surgical treatment of calculous anuria. Together with a critical examination of subparietal injuries of the ureter.

  • Morris, Henry, Sir, 1844-1926.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: On the origin and progress of renal surgery : with special reference to stone in the kidney and ureter and to the surgical treatment of calculous anuria. Together with a critical examination of subparietal injuries of the ureter. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    34/306 (page 22)
    mfundibulum through the stricture to the bladder, and the ends of the incision were drawn together, by the Heinecke- Mikulicz method, by means of two fine silk sutures, passed after the manner of Lembert (see Figs. 4 and 5). The wound of the renal parenchyma was sutured with silk. Nephropexy was then performed by Vulliet's plan. The wound healed entirely by first intention, and there has been no return since of the symptoms which led to the operation. Resection of the Ureter is the operation whereby an inch or two, or a little more, of the duct is removed, and the ureter is united to the infundibulum, or the divided ends of the ureter to one another, as the case may be, so as to restore the continuity of the conduit. It was first proposed by Marcel Beaudoin in 1891, and first performed by Krister in May, 1891. Kttster's case is a most important one, not only as being the pioneer case, but as a serious warning that we ought to practise conservatism in dealing with the kidney; and an indication that in hydro- nephrosis, nephrectomy ought to give place to nephrotomy, or to ureterotomy, in any case in which either of these operations gives promise of success. Ktister reported his case at the Congress of Surgeons held in Berlin in 1892.* The patient was a boy, aged thirteen, with only a single kidney, who for two years had passed all his urine through a fistula, following lumbar nephrotomy, for hydronephrosis. The cause of the hydronephrosis was a very tight stricture of the ureter near the renal pelvis. The strictured part of the ureter was excised, and the cut end of the ureter was sutured to the renal pelvis. . By the end of four months from the date of this operation all the urine was passed naturally, and the fistula was quite closed. In the discussion on Krister's communication at the Berlin Congress, Trendelenburg and Alsberg reported that they had each done a similar operation. Trendelenburg added that his patient had died from intestinal obstruc- tion, due to adhesions between the hydronephrotic sac and the colon. Cramer of Cologne followed Krister's lead in a case of hydronephrosis in 1893; and again in operating on a case of * Archiv fur Klinisclic Chirnrgie, vol. xliv., 1892, p. 850.