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September 17, 1910


Author Affiliations


JAMA. 1910;55(12):989-991. doi:10.1001/jama.1910.04330120011002

The word "extracapsular" is used in the title of this paper to imply fixation of the kidney by a method entirely external to the tunica fibrosa as distinguished from any method that implies either invasion of that tunic or surgical injury to the kidney itself.

The further significance of the term as it is here used may be made clear by a brief description of the essential features of the operative procedure that I have employed for the last several years—indeed, since 1904— for the anchorage of the pathologically movable kidney,1 as follows:

TECHNIC OF EXTRACAPSULAR NEPHROPEXY  1. The patient is placed in the classical position on the well side with a firm pad, preferably pneumatic, under the same side. The equally classic incision about 1 cm. below the costal margin and about 10 cm. in extent is made obliquely downward and forward. This dissection is carried through the