TORSION OF THE SPERMATIC CORD. 



205 



of forceps, and thus crushing the walls of the blood-vessels, a condition 

 favoured by roughening the jaws of the forceps, and partly by rotating 

 the second pair of forceps very slowly, in which case the blood-vessels 

 are the last parts to be torn through. 



Most forceps are defective, inasmuch as the}' take too broad a hold 

 of the spermatic cord, and thus render the effects of torsion irregular. 



Fig. 235. — Bayer's forceps with screw and instantaneous release. For 

 holdino' the cord. 



The anterior and posterior margins of the spermatic cord are torn 

 through after the second forceps has been turned once or twice, and 

 the blood-vessels are divided without having first been sufficiently 

 twisted. Bleeding is then very liable to occur, especially if a second 

 forceps be used for turning, and if the hold on the spermatic cord be 

 too short. To ensure regular torsion the spermatic cord should first 

 be rolled together into a cylindrical mass, as occurs in using Togl's 

 forceps. The blood- 

 vessels thus become 

 the last portions to 

 rupture, and only 

 yield after prolonged 

 twisting. The torn 

 portions of the sperm- 

 atic cord appl}' them- 

 selves around the 

 lumen of the vessels, 

 which the}- com- 

 pletely close, so that no bleeding occurs. As, however, with Togl's 

 ordinary forceps it is difficult to compress the spermatic cord sufficiently, 

 the handles have since been niuch lengthened and the jav.'s shortened, a 

 modification which has greatly increased their efficiency. 



The cord should be rotated quite slowly. The testicle is grasped 

 with the hands, or with a second forceps, and regularly and slowly 



Fig. 236. — Robertson's forceps for torsion of the cord, 

 as adopted by Moller. 



