—Marion28 reviewed his ideas on the technic of total ureteronephrectomy. He does not use the large lumbo-abdominal incision. To perform complete nephro-ureterectomy, a lumbar incision and a low abdominal incision are necessary. He employs the lateral vesical route to reach the pelvic ureter, pushing the peritoneum aside, loosening the bladder from the pelvis and approaching the ureter at the level of the vesical wall. A definite procedure cannot always be determined before operation. In some cases the condition is definite and the plan can be outlined before operation, particularly in cases such as those of ureteropyonephrosis. In other cases the necessity for removing the ureter may not be ascertained until the kidney has been examined. Marion expressed the belief that in these cases the most simple procedure is to approach the ureter by the latero-iliac route, somewhat high up, and free the ureter down to the bladder.
SCHOLL AJ, JUDD ES, KEYSER LD, VERBRUGGE J, KUTZMANN AA, HEPLER AB, GUTIERREZ R. A REVIEW OF UROLOGIC SURGERY. Arch Surg. 1933;26(4):712-734. doi:10.1001/archsurg.1933.01170040175014