Surgery; its theory and practice . the external abdominal ring;that the stricture, whether the hernia be direct or indirect,should be divided directly up7vards, so as to avoid the epigastricartery; and that when combined with retained testicle a trusswith a -^-shaped pad should be worn, if practicable, above thetesticle. If the truss causes the testicle to become frequentlyinflamed, the testicle had better be removed (see retained testis).A FEMORAL HERNIA is onc that cscapcs into the femoral sheath,and nearly always internal to the femoral vessels, though in veryexceptional cases it has been f
Surgery; its theory and practice . the external abdominal ring;that the stricture, whether the hernia be direct or indirect,should be divided directly up7vards, so as to avoid the epigastricartery; and that when combined with retained testicle a trusswith a -^-shaped pad should be worn, if practicable, above thetesticle. If the truss causes the testicle to become frequentlyinflamed, the testicle had better be removed (see retained testis).A FEMORAL HERNIA is onc that cscapcs into the femoral sheath,and nearly always internal to the femoral vessels, though in veryexceptional cases it has been found external to them. As a rule,it leaves the abdomen at the femoral ring, and after passingdownwards through the femoral canal, emerges at the saphenousopening, and then turning upwards and outwards over the ftilci-form process of the fascia lata, passes, should it further increasein size, over Pouparts ligament on to the aponeurosis of the ex-ternal oblique muscle of the abdomen. The neck of the sac is FEMORAL HERNIA. 647 •#C^|^ situated at \ht fetrioral ring (Fig. 312), and is therefore boundedin front by Pouparts ligament, behind by the bone, internally bythe sharp wiry edge of Gimbernats ligament, and externally bythe femoral vein, from which it is .only separated by the inner-most septum of the femoral sheath. The spermatic cord is closeabove it; the epigastric artery passes a little external to it; butthere is no structure of importance, as a rule, on its inner, andupper and inner side. The obturator artery, however, may begiven off from the epigastric or external iliac artery, and encirclethis part of the ring in its course to the obturator foramen (Fig. 312). It is then in great danger ofbeing wounded in dividing the strict-ure. Fortunately, however, althoughthe artery often rises in this abnormalmanner, it does not then, as a rule,take the above-mentioned dangerouscourse, but passes along the outerside of the ring where it is out ofdanger. The coverings of a
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectsurgery, bookyear1896
