406 



OPERATIOXS ON THE DIGESTIVE APPARATUS. 



Fig. 385. 

 Herniotomes of Colin. 



as a ring in the wall, a post, a tree, or 

 other immovable object. If the opera- 

 tion is to be performed at night, which 

 is too often necessarily the case, the 

 presence of additional assistants will 

 probably be required, in order to insure 

 an abundant amount and proper man- 

 agement of Hght, which is indispensable 

 in so delicate a dissection. 



In operating, the surgeon kneels be- 

 hind the patient and ^ith a curved bis- 

 toury begins by making a long incision 

 upon the tumor, parallel with the long 

 axis of the testicle. 



This incision is similar to that which 

 is made in castration with covered testi- 

 cles, and must involve only 

 ' the scrotum, the dartos, 

 and the first layers of the 

 lamellated cellular tissue 

 which unite this last to the 

 tunica erythroidea. The 

 remaining portion of this 

 lamellae is then carefully 

 incised, iintil the fibrous 

 coat is exposed, and the 

 tumor is entirely enuclea- 

 ted from its envelojDe of 

 cellular tissue. This done, 

 the fibres of the tunica 

 erythi-oidea are scraped 

 apart with the point of the 

 straight bistouiy, until the 

 vaginal sac has been open- 

 ed, which the operator dis- 

 covers by the appearance 

 of a stream of liquid pass- 

 ing through. The canula- 

 ted director is then intro- 

 duced into the opening and 



