. A manual of operative surgery . uring its walls hehas weakened it at all,provided that aseptichealing be secured. 3. Complete Oblitera-tion of the InguinalCanal.—-The cord beingfreed from the internalring down to the ospubis and the sachaving been dealt with,the cord is held for-ward by blunt hooks,and a series of suturesis passed through theedges of the external FIG- I01-—radical cure of inguinal hernia. &. [After Kelly.) ODliqUe, tne internal Complete obliteration of inguinal canal by sutures. TheOblique, and the trans- spermatic cord is held forward ona hook. versalis on the one side, and
. A manual of operative surgery . uring its walls hehas weakened it at all,provided that aseptichealing be secured. 3. Complete Oblitera-tion of the InguinalCanal.—-The cord beingfreed from the internalring down to the ospubis and the sachaving been dealt with,the cord is held for-ward by blunt hooks,and a series of suturesis passed through theedges of the external FIG- I01-—radical cure of inguinal hernia. &. [After Kelly.) ODliqUe, tne internal Complete obliteration of inguinal canal by sutures. TheOblique, and the trans- spermatic cord is held forward ona hook. versalis on the one side, and the lower part of the external obliqueon the other side (Fig. 101). The lowest sutures will pass onlythrough the former pillars of the ring. Room must be left at theupper end for the cord, which is now placed on the outer surfaceof the external oblique. If necessary, one or two stitches may bepassed above the new aperture for the cord, but it is a mistaketo make this unduly narrow, as the circulation of the testis will. 350 ABDOMINAL OPERATIONS [part ii be interfered with. There is no reason for the proposal to exciseany of the spermatic veins unless there be a coincident varicocele. The stitches should be placed close together, and whilstsome advocate silk as the material, we strongly recommendkangaroo tendon. When the latter material is used and duecare is taken as to asepsis, it is possible to perform a hundredsuccessive operations for radical cure without the slightesttrouble arising from a single stitch. The same can hardly besaid if silk be used. Stout catgut is used by many surgeons,and it probably lasts a sufficient time in the tissues to attain itsobject. Chromic catgut is especially liable to work out, andshould never be used for buried sutures. A word of caution is necessary as to the deep epigastricvessels. In passing the uppermost sutures it has happenedthat the epigastric artery has been wounded and most serioushaemorrhage has ensued, even necessitating ligat
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