. The anatomy and surgical treatment of hernia. firm connective-tissue bandsthroughout the lower portion of its following figure shows the re-enforc-ing bands of subperitoneal fascia whichnormally strengthens the internal rings,both inguinal and crural. Although this fascia has become path-ologically dilated and deformed in hernia,it is yet easy, by penetrating it with theneedle at some distance upon either side,to find a firm fibrous margin for the sup-port of the sutures. When these aredrawn together the relaxed tissue is intra-folded, and a proliferation of connective-tissue cell
. The anatomy and surgical treatment of hernia. firm connective-tissue bandsthroughout the lower portion of its following figure shows the re-enforc-ing bands of subperitoneal fascia whichnormally strengthens the internal rings,both inguinal and crural. Although this fascia has become path-ologically dilated and deformed in hernia,it is yet easy, by penetrating it with theneedle at some distance upon either side,to find a firm fibrous margin for the sup-port of the sutures. When these aredrawn together the relaxed tissue is intra-folded, and a proliferation of connective-tissue cells along the line of suturingmakes a firm support to the posteriorborder of the reformed canal. The follow-ing plate, taken from Mr. Coopers work,should be studied in conjunction withPlate XXI; but it is introduced in this connection to show the dilatation and deformityof the internal ring when the hernia is at all pronounced. At x, although the hernia isregarded as incipient, the changes which have ensued are so marked that the inner mar- «^. Fig. 27.—Dissection of internal inguinal and crural ringsfrom internal surface, the peritonEeum and fascia be-ing removed : a, external iliac artery; i>, epigastricartery, branch oi a; d, deep circumflex iliac, lyingin Hesselbachs triangle ; e, rectus muscle ; /, fasciatransversalis ; £-, vas deferens or spermatic duct; /i,spermatic plexus of veins with artery and nerves;z, obliterated cord of hypogastric arterj-; i, lym-phatic glands. At the internal ring may he seensubperitoneal fascia /, enveloping the cord /i. Plate LXIII .
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Keywords: ., bookcentury1800, bookdecade1890, booksubjecthernia, bookyear1892
