. Annals of surgery . Fig. 3.—Ureter fixed upon the button.(One-half actual size.) with the underlying plate, and is kept in place by passing a styletthrough the opening situated in the tube. (Figs, i, 2, and 3.) With a fine intestinal needle, a purse-string suture is inserted inthe bladder at the site selected for reception of the ureter, and in the OENITO-UBINARY ORGANS. 379 area so mapped out an incision of suitable length is made for theintroduction of the large part of the button. The purse-stringsuture is drawn up and tied, bringing the suture line into close con-. FiG. 4.—Technique of i
. Annals of surgery . Fig. 3.—Ureter fixed upon the button.(One-half actual size.) with the underlying plate, and is kept in place by passing a styletthrough the opening situated in the tube. (Figs, i, 2, and 3.) With a fine intestinal needle, a purse-string suture is inserted inthe bladder at the site selected for reception of the ureter, and in the OENITO-UBINARY ORGANS. 379 area so mapped out an incision of suitable length is made for theintroduction of the large part of the button. The purse-stringsuture is drawn up and tied, bringing the suture line into close con-. FiG. 4.—Technique of implantation of the ureter into the bladder bymeans of the Boari button. tact with the tube. The stylet is withdrawn, allowing the springof the button to bring the vesical wall into contact with theureter. It is best to reinforce this approximation by some sutures 380 SURGICAL PROGRESS. passed through the peri-vesical and peri-ureteral tissues. Anotherand better plan consists in applying the original purse-string sutureonly to the vesical mucous membrane, and then attaching two flapsderived from the muscular coat over the ureter, giving a broadersurface of contact, and also obtaining an oblique insertion in imita-tion of the natural anatomical arrangement. The anastomosis canalso be made extraperitoneal, after Novaros method, by stripping offthe peritoneum from the pubes to the site of the implantation andpacking with gauze. The button is easily removed after dilating the urethra, andeither catching it iu forceps or seizing the thread attached to thebase of the
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
