. Surgery, its principles and practice . and down tothe scrotum. Sometimes the pouch extends to the bottom of the scrotumeven in cases in which the testicle has never been out of the abdominal cav-ity. This pouch of peritoneum is covered by the cremasteric muscle andfascia and the transversalis fascia. These thin layers should be dividedand the peritoneal pouch opened (Fig. 313). The vaginal process of peri-toneum should be divided transversely well above the testicle. Care shouldbe taken not to injure the cord, and in children, where the peritoneal pro-cess is as delicate as tissue paper, the
. Surgery, its principles and practice . and down tothe scrotum. Sometimes the pouch extends to the bottom of the scrotumeven in cases in which the testicle has never been out of the abdominal cav-ity. This pouch of peritoneum is covered by the cremasteric muscle andfascia and the transversalis fascia. These thin layers should be dividedand the peritoneal pouch opened (Fig. 313). The vaginal process of peri-toneum should be divided transversely well above the testicle. Care shouldbe taken not to injure the cord, and in children, where the peritoneal pro-cess is as delicate as tissue paper, the dissection must be made with greatcare and with small instruments (Fig. 314). After complete transversedivision of the vaginal process the upper end is closed with a catgut liga-ture, as is the sac in a hernia operation, and the lower end is closed with apurse-string suture, making a tunica vaginalis for the testis (Fig. 315). UNDESCENDED AND MISPLACED TESTICLE. 595 Then, with a gauze sponge, the peritoneum is carefully wiped off from. Fig. 315.—Bevans , Upper end of vaginal process of peri-toneum ligated; 2, purse-string suture closinglower end of vaginal process and forming atunica vaginalis for the testicle. Fig. 316.—Bevans lengthened and testicle freed andready for replacement; 2, the spermaticvessels; 3, the vas deferens.
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