56 SPRINGTIME SURGERY 



it has descended into the canal, producing a com- 

 plete or partial flanker. If it is a complete 

 flanker, all of the testicle having passed through 

 the inner ring, the case is handled as a plain colt. 

 If only a part of the testicle is descended, ignore 

 the condition and operate as a ridgling, making 

 the opening at the usual point. In the partially- 

 descended testicle it is almost always the tail of 

 the epididymis that has descended and the ring 

 ha3 contracted down around it so that the testicle 

 cannot pass through and usually cannot be pulled 

 through with safety to the ring. I have found 

 that these are best handled by passing up along 

 the side of the descended tail and, making the 

 opening at the usual place, pulling the descended 

 portion back into the belly and out the opening. 

 Opening the Peritoneal Cavity.— I have 

 satisfied myself that the best place to open into 

 the peritoneal cavity from the upper end of the 

 canal is at a point just in front of the shaft of 

 the ilium, at the upper part of the internal in- 

 guinal ring. In operating, I locate the internal 

 ring and then proceed upward and somewhat 

 backward until I come to the point where the 



