Movable kidney : with a report of twelve cases treated by nephrorrhaphy / by George M. Edebohls.

  • Edebohls, George M. (George Michael), 1853-1908
Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: Movable kidney : with a report of twelve cases treated by nephrorrhaphy / by George M. Edebohls. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tion was not always ati easy matter, and frequently the operation had to be interrupted to readjust them. He had, overcome all these difficulties by operating with the patient lying flat upon the abdomen and anterior surface of the chest upon the table. After the lumbar region had been pre- pared for operation by washing, the patient was lifted sufficient!}’' to allow the cylindrical air cushion shown to be placed trans- versely across the table beneath her abdomen. The air pressure crowded the abdominal viscera towards the lumbar regions, carry- ing the wandering kidney or kidneys back to their normal situation. The air cu.shion was a perfect cylinder of rubber, twelve inches long by eight inches in diameter, and inflated by a foot-ball valve and key, the valve being .secured in the centre of one head of the cylinder. manufacturer of rubber goods could make one, or J. Reynders & Co., 303 Fourth Avenue, New York, would sup- ply them. The maintenance of anesthesia w’as easy in the position des- cribed, the face being turned to one side and the elevation of the abdomen upon the cushion freeing the chest from pressure by the table. In performing the operation on the Edebohls table the anterior surface of the thighs rested upon the table, while the legs and feet were suspended by means of the Edebohls leghold- ers. In using a longer table the entire lower extremities lie upon the table. The position should prove a good one als^ffir other operations upon the kidney, as well as for sacral pr^ect- omy or hysterectomy, and in his next case of either of the latter he proposed to give it a trial. The use of this cushion had also enabled Dr. F^debohls to im- prove upon the technique of the operation itself. Instead of passing the sutures through the kidney in the depths of the wound, he now took the kidney to be operated upon out through the lumbar incision, and thus having free access to the entire organ he was able to do much more accurate work, splitting and reflecting the capsula propria to the exact extent required, and in the exact situation desired. He then passed his sutures, to the number of five generally, through the kidney, after which the kidney was replaced in the body and the ends of the kidney sutures passed on each side through the muscles and fascia. Previous to t)dng them he had the cushion taken awa}'^, .so as to remove the tension upon the lips of the lumbar incision and per- mit of the easy approximation of the deep portions of the wound, so that cutting of the buried sutures through the kidney sub stance by reason of too great tension was avoided. He was per- fectly satisfied both with the technique and the results of nephrorr- haphy as he now practiced it. He had thus far operated upon twenty-four cases, in three of them fastening both kidneys at the same sitting.
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