SCROTAL REPLACEMENT OF CRYPTORCIIID TESTKS. 115 



indicated that the experimental animal should have but one 

 testis displaced into the abdomen while the other develops 

 normally, and this report is restricted to material of this operative 

 history. 



The operative procedures, with perhaps minor variations, 

 have consisted in opening the abdomen in a mid-ventral incision, 

 retracting one testis into the abdomen, loosening its connections 

 with the scrotal pouch, and fastening the testis high up in the 

 abdomen by a suture passed through the epididymis and fastened 

 to the body wall; this prevents possible return to the scrotal 

 pouch, inasmuch as the inguinal canal was left open for future 

 operative return of the testis to the scrotum. The opposite 

 testis remained normal throughout the experiment or until the 

 second, or replacement, operation at a later date. Four to five 

 months after testis elevation the abdomen was opened a second 

 time, the ligatures and adhesions cut and the testis replaced in 

 the scrotal pouch in its usual position; a suture passing from 

 the epididymis through the scrotal wall to the outside assisted 

 in holding the organ in its desired location. Replacement of 

 the testis without scrotal injury is not always successful. The 

 absence of the growing testis from the scrotum results in a 

 smaller pouch and coupled with this factor is the great increase 

 in the fat body attached to the testis; often the testis to be 

 replaced is but a fraction the size of its appended fat body. 

 Attempts have been made to cut away the major portion of the 

 fat body, without undue injury to the vascular plexus located 

 within it, but the formation of adhesions of the entire mass 

 replaced in the scrotal pouch have many times prevented a proper 

 realization of the powers of the gland for recovery; adhesions 

 often interfere decidedly with normal testicular function. 



In most cases the opposite normal testis was removed at the 

 replacement operation and on some occasions the degenerate 

 testis was carried to the opposite side and replaced in the position 

 of the normal testis in the larger scrotal pouch ; the vas deferens 

 often prevents the testis from reaching the bottom of the opposite 

 scrotum and in some cases it has been purposely cut away to 

 avoid such interference. It is now known that the testis does 

 not have to be connected with its vas deferens to produce 



