It was in 1883 that two French veterinarians, Renault and Delafond, of the Alfort school, introduced the use of instruments in the operation, as an improvement upon the manual methods and their effects on the sequelæ, though it is said to have been already practiced in Germany as far back as the last century. The instruments employed are two forceps of peculiar construction, and which were more or less modified, one of which (fixing forceps, [Fig. 3],) is to be applied upon a fixed point of the cord, where it is suffered to remain, and the other (moving forceps, [Fig. 4],) is employed to accomplish the rotation of the testicle and the lower end of the cord. Those of Renault and Delafond or of Reynal are now in general use. Those of Beaufils ([Fig. 5]) are, we believe, too complicated for general use.
Fig. 5.
COMBINED FORCEPS OF M. BEAUFILS.
Modus Operandi.—In the first step of the operation, the ordinary manipulations of the division of the envelopes, the opening of the sac and exposure of the testicle being accomplished, and the envelopes being carefully pushed upwards, the torsion and excision of the cord are effected in the following manner: The entire cord is embraced by the fixing forceps (see [Fig. 6]), or only its anterior fasciculus if the posterior septum has been cut, as in the process by free torsion above the epididymis. An assistant, seizing it from before backwards between its open branches and strongly closing them, holds it firmly, without pulling upon the cord. The operator then grasps the cord with the moving forceps above the testicle, and a little below the point held by the assistant, leaving a small space between the instruments, and closing his own tightly, begins the movement of torsion, which he directs from left to right. For this he sometimes requires both hands, one of them keeping the instrument in place, while the other continues the rotation as described. Ten or fifteen turns of the forceps are usually sufficient to complete the rupture of the cord, the artery, owing to its facility of elongation, being the last part to give way. The testicle then separates, being held in the branches of the moving forceps; the fixing forceps are removed, and the cord is drawn upwards into the vaginal sac. It is important in this operation to caution the assistant against drawing on the cord during the struggles of the animal, consequent upon the pain caused by the first application of the instruments, and the pressure upon the parts when held between their inflexible iron jaws; but on the contrary, to maintain it as closely as possible against the inguinal region.
Fig. 6.
OPERATION OF LIMITED TORSION.
This process of castration is one of the most rapid of all the forms of operating. The only hemorrhage likely to occur is merely that of the small testicular artery, if it should happen to be divided when the torsion is confined to the front portion of the cord.
Below the Epididymis.—This process differs from the preceding only in the fact that instead of holding the cord between the fingers, it is held by the fixed forceps, the use of the moving instrument being rendered unnecessary by the slightness of the adhesion of the seminal gland to its appendix.