File:The practice of surgery (1910) (14777002624).jpg

Identifier: practiceofsurger00mumf (find matches)
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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gery). duce any hernia which may be present. Then cut across the vaginalprocess above the testicle and secure the proximal stump as in the case UNDESCENDED TESTICLE 467 of a hernia. Sew up the distal portion of the vaginal process about thetesticle, and so furnish that organ with a tunica vaginalis. It nowremains to bring the testicle into the scrotum, and this is done by aprocess of traction on the cord and the division of retaining bands.To this end the cord is stripped up, leaving nothing but the vessels andthe vas, which in turn must be separated carefully from the parietalperitoneum. By this means, in nearly all cases, the cord may be elon-gated satisfactorily. A pocket in the scrotum is then readily made withblunt-pointed scissors and the fingers; the testicle is dropped into thepocket and is held in place by a catgut purse-string ligature, passedsubcutaneously about the neck of the scrotum. The surgeon thenrestores the wounded canal, sews up the inguinal hernia, and dresses the
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Fig. 303.—Bevan6 operation. Mak-ing pocket in right side of scrotum forreception of the testicle (Bevan in KeensSurgery). Fig. 304.—Bevans operation. Su-tures closing the wound (Bevan in KeensSurgery). wound with a firmly applied spica bandage. The patient should be keptin bed for two weeks at least after the operation. In rare cases one finds that the cord cannot properly be drawn downand that this is due to short spermatic vessels, and not to a short vas.Bevan has found, and his experience coincides with my own, that thespermatic vessels may be cut away in such cases, without danger,leaving the vas and its vessels only. When this is done, a sufficientlylong cord is obtained. Absence of the testicle is a condition allied etiologically to unde-scended testicle. In two cases of apparent double undescended testicleI have been unable at operation to find more than one testicle in eachpatient. I did find, however, on the opposite side, an attenuated cord,terminating in a pinch of tiss

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