. Manual of operative surgery. Fig. 838. Fig. 838, 839 and 840.—Maydls operation. Fig. 840. bladder-wall is inserted like a patch into the incision in the sigmoid. Note thatno great separation of the lower ends of the ureters from their surroundings isrequired; the loop of sigmoid is brought down to the ureteral portion of blad-der, which is, of course, mobilized. The implantation of the segment of blad-der-wall containing the ureters, instead of the implantation of the uretersthemselves, is the important principle in the operation; by it the normalureteral valves or sphincters are r
. Manual of operative surgery. Fig. 838. Fig. 838, 839 and 840.—Maydls operation. Fig. 840. bladder-wall is inserted like a patch into the incision in the sigmoid. Note thatno great separation of the lower ends of the ureters from their surroundings isrequired; the loop of sigmoid is brought down to the ureteral portion of blad-der, which is, of course, mobilized. The implantation of the segment of blad-der-wall containing the ureters, instead of the implantation of the uretersthemselves, is the important principle in the operation; by it the normalureteral valves or sphincters are retained and infection is prevented from as-cending the ureters. Several modifications of Maydls operation have beensuggested, but most of them merely complicate the technic. VI. Makkas Operation.—(Zentralblatt fur Chir., 1910, No. S3-) Toavoid the dangers of ascending infection inseparable from any method by whichthe ureters are made to discharge into a cavity containing faeces, Makkas ex-cludes the caecum from the rest of
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