Operative surgery . ch is often quite well marked. If thesurgeon divides the fascia transversalis under the impression that it is thesac, he will then mistake the subserous fat for omentum in the fallacy will be quickly dispelled, however, when he attempts to find theintestine, or to return the supposititious omentum to the abdominal cavity. The Recognition of the Sac—The sac is globular in form, of a bluishcolor, tense, and often transparent. A sense of fluctuation is frequently dis-cernible at its lower portion. It can be pinched up between the thumb andfinger, and its smooth
Operative surgery . ch is often quite well marked. If thesurgeon divides the fascia transversalis under the impression that it is thesac, he will then mistake the subserous fat for omentum in the fallacy will be quickly dispelled, however, when he attempts to find theintestine, or to return the supposititious omentum to the abdominal cavity. The Recognition of the Sac—The sac is globular in form, of a bluishcolor, tense, and often transparent. A sense of fluctuation is frequently dis-cernible at its lower portion. It can be pinched up between the thumb andfinger, and its smooth serous surfaces can be rubbed together, if they be notadherent to the contents. This manifestation is diagnostic. Before the sacis opened, the intestine may be pinched up in the same manner, but it willquickly and easily escape the grasp because of the smooth opposed serous 902 OPERATIVE SURGERY. surfaces. If a small hollow needle be introduced, a drop of fluid will escape;this is characteristic of a hernial Fig. 1099.—Instruments employed in herniotomy. Large and small scalpel, b. Hernia bistoury, c Curved, probe-pointed bistoury, director, e. Common director. /. Curved and straight scissors. /(. Dis-secting and mouse-tooth forceps, i. Kangaroo tendon in glass tube. /, I. Blunt andhooked retractors, k, m. Tenaculum and blunt hook. n. Silver probe, o. Needleholder, p. Traction loops, q. Small clamp and small needle carrier, r. Curved andstraight needles, s. Chromicized catgut and silkworm gut. Good light is veryimportant. opp:kati()ns on viscera connected with peritonaeum. 003
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