File:Buffalo medical and surgical journal (1893) (14597019617).jpg

Identifier: buffalomedicalsu3318unse (find matches)
Title: Buffalo medical and surgical journal
Year: 1894 (1890s)
Authors:
Subjects: Medicine General Surgery
Publisher: Buffalo : Joseph Warren & Co., Printers
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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loperation anyway, owing to the fact that, with all of Naturesdevices, she has failed to let the structures of the spermatic cord 1. Read before the Pan-American Medical Congress, in Washington, D. C, September6, 1893. milliken: radical cure of inguinal hernia. 147 make their exit from the abdominal wall, without leaving eachsubject liable to hernia—no age being exempt. Our laparotomistswill, I think, agree that any abdominal section is likely to befollowed by hernia, whatever precautions are taken in closing thewound; and from our herniotomies, when the testicle is notsacrificed, I dont see how we can but expect a larger percentageof recurrences than they get of the ventral variety. So long as it is not deemed advisable to sacrifice the testicle,the best that we can hope for is to imitate Nature and reestablishthe obliquity of the canal. This is best done, in my opinion, bythe method of Bassini; and I will endeavor to show its advan-tages over the other two methods above mentioned.
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Fig. 1. First, the aponeurosis of the external oblique muscle is dividedover the cord structures, until the internal ring is well exposed ;the flaps are separated from their underlying structures until theconjoined tendon on the upper, and the shelving process ofPouparts ligament on the lower, are brought into view. Thecord structures and the hernial sac are next lifted out of their bed 148 MILLIKEN : RADICAL CURE OF INGUINAL HERNIA. en masse, after which the sac is isolated, opened, and tied off atthe highest point. Secondly, with the cord held out of the operation field by ablunt hook, or the finger of an assistant, the conjoined tendon onthe upper is sutured to the shelving process of Pouparts on thelower by means of the kangaroo tendon, or of chromatized catgut,

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