Operative surgery . ected tothe fixation of a troublesome movable or floating kidney. The former con-dition is quite common and usually acquired; the latter is rare and congeni-tal. The right kidney is mobile much more frequently than the left; bothmay be similarly affected together, the left rarely alone. 826 OPERATIVE SURGERY. lite Operation.—Place tlie patient with the sound side resting on a hardpillow so as to make the field of operation convex and to increase the dis-tance between the last rib and the crest of the ilium (Figs. 103G and 1037);locate the twelfth rib and half an inch below
Operative surgery . ected tothe fixation of a troublesome movable or floating kidney. The former con-dition is quite common and usually acquired; the latter is rare and congeni-tal. The right kidney is mobile much more frequently than the left; bothmay be similarly affected together, the left rarely alone. 826 OPERATIVE SURGERY. lite Operation.—Place tlie patient with the sound side resting on a hardpillow so as to make the field of operation convex and to increase the dis-tance between the last rib and the crest of the ilium (Figs. 103G and 1037);locate the twelfth rib and half an inch below at the outer border of the erectorspinae begin the incision (Figs. 1043, perpendicular C, 1032, and 1033); carrythe incision downward along the outer border of the sheath of this muscle,which should not be opened, toward the iliac crest for three or four inches;divide the superficial tissues down to the posterior border of the latissimusdorsi (Figs. 1032 and 1033); draw forward the fibers of this muscle and divide. Fig. 1034.—The surgical anatomy of the right kidney, transverse section, a. Externaloblique muscle, h. Peritonauni. c. Transversalis muscle, d. Internal oblique mus-cle, e. Peritonaum. /. Latissimus dorsi muscle, g. Anterior layer of lumbar fas-cia, h. Middle layer of lumbar fascia lying above transversalis fascia, i. Posteriorlayer of lumbar fascia. the lumbar aponeurosis connected with the internal oblique and transversalismuscles down to the quadratus lumborum ; ligature the lumbar arteries ; pushaside or divide, as necessary, the outer border of the quadratus lumborummuscle; cut through the anterior lamella of the lumbar fascia and expose thefascia transversalis (Fig. 1034); divide this fascia, and thus expose to viewthe fatty capsule of the kidney; draw apart the borders of all the divided
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
