920 
DEPARTMENT OF SURGERY. 
an extra-peritoneal operation. The most reliable method of lo¬ 
cating calculi is by the use of the X-ray ; other means are unre¬ 
liable in domestic animals. 
B. Surgical Operations on the Ureter .—In the brief consid¬ 
eration of this subject we shall only consider the following op¬ 
erations which we consider applicable to veterinary surgery : 
I. Ureterotomy. 
II. Implantation of ureter into rectum (uretero-rectostomy). 
III. Uretero-Ureterostomy (anastomizing ureters). 
I. Ureterotomy. —This operation consists of an incision made 
into the ureter ; and the.proeedure may be executed either with¬ 
out entering into the peritoneal cavity, or by gaining access to 
the ureter thiough the peritoneal cavity; we shall therefore 
consider two methods of performing ureterotomy : 
1. Extra-peritoneal ureterotomy. 
2 . Intra-peritoneal ureterotomy. 
1. Extra-peritoneal Ureterotomy. —By this method of per¬ 
forming the operation, the ureter is reached through the ab¬ 
dominal parietes ; a longitudinal incision is made on a line ex¬ 
tending from the posterior costal border of the last rib to the 
anterior border of the ilium, near the end of the transverse pro¬ 
cesses of the lumbar vertebra. The extent and exact location 
of the incision depends upon the location of the obstruction. 
When the ureter is found and the obstruction detected a longi¬ 
tudinal incision is made in the duct and foreign matter removed 
and the wound thoroughly cleansed by irrigation. If the incision 
is small it is not necessary to suture it, but if it is long a few 
catgut sutures should be applied to keep the edges together. 
The Lembert sutural loosely ligated will answer. The wound 
is treated as all wounds requiring drainage. (See Review, Vol. 
XXIIp No. 12, Stir. Dept. ) 
2 . Intra-peritoneal Ureterototny is performed by opening 
the abdominal cavity. This method is not recommended for 
herbivora or omnivora, but could be used in carnivorous ani¬ 
mals without much inconvenience. The main trouble with 
this procedure is the inconvenience caused by the intestine ; 
this, however, can be partly obviated by walling them off with 
sponges. When this is accomplished, the operation (uretero¬ 
tomy) is completed by making a longitudinal incision in the 
ureter at the point selected ; this incision must not be made 
larger than actually necessary to remove the obstruction (cal¬ 
culi generally). The incision is sutured by Eembert’s suture, 
which can be reinforced by including a fold of peritoneum in a 
