The first step is the most difficult for the surgeon as well as the most painful to the horse, though the contrary is the fact where the subject is an ox. The operator, stationing himself behind the animal, grasps the testicles with both hands ([Fig. 16]) and quickly draws them down into the scrotum. Holding them there with the right hand, with the left he raises the scrotum by the lower part, firmly pulling upon it downwards and slightly from before backwards. The testicles are then moved upward and downward in the sac, carrying with them the fibrous covering. During this time a peculiar crackling sound is heard, which is caused by the tearing apart of the fibres of the cellular tissue lying between the dartos and the fibrous coat. This laceration is sometimes difficult to effect, especially in aged animals, in which case the up and down motion of the testicles will require a greater number of repetitions before the adhesions are torn.
Fig. 17.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Position of the left hand at the beginning of the second step.
Fig. 18.
DOUBLE SUBCUTANEOUS TORSION IN CATTLE.
Second step.
The second step consists in the displacement or dislocation of the testicle, which is accomplished in the manner following: The testicles being pushed well upwards in the vaginal sac, one of them, the left, for example, is drawn well downwards with the left hand, which grasps the cord above the epididymis ([Fig. 17]), the thumb resting on the back of the cord, and the remaining fingers in front of it, while the right hand, placed in pronation, pinches the inferior part of the scrotum. Maintaining these dispositions, the testicles are displaced by the simultaneous action of both hands, the left pushing the cord from above downwards and from before backwards, in such a manner as to depress as much as possible the superior extremity of the gland, while with the fingers of the right hand, resting by their dorsal face against the posterior part of the testicle ([Fig. 18]), the inferior extremity of that organ is pushed upwards. Without losing hold of the envelope, the movement of this hand gives way to these opposite and simultaneous pressures, that of the left hand tending to lower the head of the testicle, and that of the right elevating its tail, and the gland is being flexed upon the cord from which it is suspended, backwards and upwards. At the moment when the testicle forms an acute angle with the cord, the thumb of the left hand, resting upon the cord, comes into action to aid in the displacement by making a point d’appui upon the inferior extremity of the organ, which now occupies the superior position, in such a manner that the spermatic gland is placed parallel with the cord. The manipulations are completed by pushing the testicles upwards towards the inguinal ring, to break up whatever adhesions of cellular tissue may remain. This second step of the operation being completed, the two organs are found to be so placed that they are parallel one with the other, the testicle being posterior to the cord.