. Modern surgery, general and operative. en there is irreducible omentum,or when there is a reducible hydro-cele which prevents the truss fromholding (Wm. B. Coley, in Annals of Surgery, June, 1903). The radicaloperation is almost without danger in properly selected cases, and is one of themost successful of surgical procedures. We are justified in doing the operationupon an individual under fifty years of age and free from complications, purelyto relieve him or her from the annoyance of wearing a truss. If, however, apatient is sixty years of age or over and a truss keeps the hernia up satisf
. Modern surgery, general and operative. en there is irreducible omentum,or when there is a reducible hydro-cele which prevents the truss fromholding (Wm. B. Coley, in Annals of Surgery, June, 1903). The radicaloperation is almost without danger in properly selected cases, and is one of themost successful of surgical procedures. We are justified in doing the operationupon an individual under fifty years of age and free from complications, purelyto relieve him or her from the annoyance of wearing a truss. If, however, apatient is sixty years of age or over and a truss keeps the hernia up satisfactorily,the operation should not be performed unless it is demanded by some complica-tion. Organic diseases of the heart, lungs, and kidneys are herniae (Figs. 815 and 816) are unfavorable for operation. Restora-tion is difl&cult or impossible, the forcible handling produces much shock, andrecurrence is to be expected. Restoration is difiicult or impossible because the^ Trevess Manual of Surgery, Fig. 815.—Hernia which has forfeited the rightof domicile. Treatment of Reducible Hernia 1277 abdominal cavity has contracted and holds with difficulty or cannot hold thehuge hernia. As J. L. Petit said, the hernia has forfeited the right of domicile(Fig. 815). In an operation for an enormous hernia a great quantity of omen-tum will require removal, and it may be necessary to resect a considerable pieceof intestine. If we decide to operate upon an enormous hernia, treat the patientsome time before with the object of making him lose flesh. The absorption ofmesenteric fat lessens intra-abdominal pressure. That operation may succeedin such cases is shown by Figs. 816 and 817. In any operation for the radicalcure of inguinal hernia always remember that the bladder may be part of thehernia, and be on the lookout for it. Eggenbergers table of 6778 hernial opera-tions shows 75 bladder hernise ( i per cent.). As a rule, the bladder is coveredwith cellula
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