410 
CASTRATION OF CRYPTORCHIDS. 
disinfected his hands and thrust his sleeves back above the elbow. The 
position is the same as in castration. The operation is divided into the 
following stages :— 
(1) Incision. An incision is made through the skin, about 2 to 
8 inches long, over the outer inguinal ring (perhaps slightly nearer the 
middle line) and parallel with it, and the subcutaneous tissue and fascia 
lying at this point are divided to the same extent. Any bleeding vessels 
are at once ligatured, and blood removed with sterilised pledgets of tow. 
(2) Opening the inguinal canal. The loose connective tissue in the 
inguinal canal must now be thrust on one side, both index fingers and 
possibly the thumbs being employed, and an entrance effected in the 
direction of the inner abdominal ring. The index and middle fingers of 
the hand corresponding to that particular side of the animal are then 
passed into the inguinal canal to make sure whether the processus 
vaginalis and remainder of the spermatic cord lie there. Should the 
testicle be met with at this stage (retentio inguinalis), the operation 
becomes very simple, being, in fact, just like ordinary castration. Some¬ 
times a more or less degenerated process of the tunica vaginalis, 
perhaps as large as the finger of a glove, together with the end of the 
epididymis, may be felt in the inguinal canal. In that case the inner 
abdominal ring must be examined by introducing the index finger, and 
its width discovered. Generally it is very narrow, and would not even 
permit the passage of the rudimentary testicle. As it is difficult to 
dilate, it is better in such cases to ignore the process of the tunica 
vaginalis, and aeek an entrance to the abdominal cavity alongside of it. 
When the inner abdominal ring appears wider, the processus vaginalis 
is to be divided, and the operation continued as after perforation of the 
abdominal walls. 
(8) Perforation of the abdominal walls. By passing the fingers, 
nearly to the last knuckle, into the inguinal canal, the abdominal wall 
can be felt in the depths. The posterior border of the obliquus 
abdominis and the fibres of the obliquus internus can be clearly 
distinguished. Close behind the latter is a mass of loose connective 
tissue. Degive makes his perforation at this point. Bang prefers 
entering through the inner oblique abdominal muscle at the inner wall 
of the inguinal canal, somewhat nearer the median line than the inner 
abdominal ring. This produces a “ button-hole wound,” which does 
not gape, but, on the contrary, soon comes together again and prevents 
prolapse of the bow^el. A vigorous thrust with the index and middle 
fingers during inspiration carries them through the abdominal wall into 
the peritoneal cavity. Different animals, however, present great 
differences in this respect; in some perforation is easy, in others it 
requires considerable force. 
