Modern surgery, general and operative (1919) (14783893552)

Identifier: modernsurgerygen1919daco (find matches)
Title: Modern surgery, general and operative
Year: 1919 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery, Operative
Publisher: Philadelphia : Saunders
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



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fibers that may be encountered are severed. The separatedaponeurosis of the external oblique muscle is then retracted. One has thenbrought into view the contents of the inguinal canal, the hernial sac and itsadhesions, the spermatic cord, the ilio-inguinal nerve, the internal abdominalring, the subserous fat, the cremaster muscle, the conjoined tendon, the internalobhque and its deficient origin at Pouparts ligament, the transversalis fascia,and the internal surface of Pouparts ligament. The sac is now dissected fromI Annals of Surgery, Nov., 1897. Treatment of Rediuiljlc Hernia 128: the cord and the internal ring. It is opened and its contents are inspected andproperly dealt with. It is tied high up and cut otT, and the stump is droppedinto the abdomen (Fig. 832). If the sac be congenital it is divided into twoparts: the distal portion is used to make a tunic for the testicle and the proximalportion is treated as above directed. The cord is not disturbed, and it is be- SunSpiniProtf:
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Fig. 830.—Fergusons operation: The semi-lunar skin incision (Jour. Am. Med.Assoc). Fig. S31.—Fergusons operation: Flapturned back exposing the aponeurosis andthe sac of the hernia (Jour. Am. Med.Assoc). yond doubt that Ferguson is right in saying that the testicle frequently comesto harm after operations that disturb the cord. The veins in the cord shouldnot be touched unless a varicocele also exists. Any excessive quantity ofsubserous adipose tissue should be removed. The next step in the operation isto restore the structures to their normal position; and one should remember that