266 



THE ABDOMEN AND PELVIS 



the tunica vaginalis extends upwards for a short distance on the 

 spermatic cord. 



The testis possesses a capsule of connective tissue which is known as the 

 Tunica Albuginea (Fig. 81). Anteriorly and on each side it blends with the 

 visceral layer of the tunica vaginalis ; posteriorly, where it is in relation to 

 the epididymis and ductus (vas) deferens, it is greatly thickened to form the 

 Mediastinum Testis, which sends numerous septa into the body of the testis 

 to join the tunica albuginea. In this way the organ is subdivided into 

 lobules and these contain the Seminiferous Tubules. The blood-vessels break 

 up into capillaries on the deep surface of the tunica albuginea and on the sides 

 of the septa. 



Hernial sac formed by 

 funicular process 



Serous coat of gut 



External spermatic 

 fascia 



\ Cremasteric fascia 



Internal spermatic 

 fascia 



Tunica vaginalis 

 testis 



Sinus of epididymis 

 Body of epididymis 



FIG. 8 1. Diagram of a Transverse Section through the Scrotum and Testes. 



A shows the peritoneal relationships of the vaginal type of developmental inguinal hernia. 



B shows the peritoneal relationships of the funicular type of developmental inguinal 

 hernia. 



A corresponds to Fig. 78(0), and B corresponds to an exaggerated condition of 

 Fig. 78 (if). 



In Excision of the Testis two routes are available. The 

 testis may be approached from below by incising the scrotum, 

 or the spermatic cord may be exposed above, as in the operation 

 for varicocele, and, by traction on it, the testis may be dragged 

 up out of the scrotum into the wound. The latter method is 

 preferable in malignant disease, as it enables the surgeon to 

 remove the testis, the spermatic cord, and the associated 

 lymphatics through the same incision. This route is also used 

 in tuberculous disease of the testis when there are no sinuses or 

 adhesions to the scrotum. If the latter conditions are present, the 

 lower route is adopted and the incision is planned so as to excise 

 the involved skin area. This method provides excellent drainage. 



