28. The assistant now holds these forceps and thus supports the sac so the operator can see the duct clearly.
29. The operator then carefully examines the duct preparatory to cutting it. He must be very sure not to cut it too close to the rectum or he will cut a round hole in the rectal wall because even a slight pull on the duct draws the discharge papilla outward and brings with it the wall of the rectum wrapped about the papilla so as to look like a continuation of the duct. See C, Figs 1, 2, 3.
30. By feeling carefully with the sound or the dull side of the scalpel the end of the papilla nearest the sac is readily discerned by its firmness or hardness.
31. The duct is now severed with the scalpel at a point a little way from the papilla as shown at G in Fig. 3.
32. The sac is now held free in the clamping forceps and not a particle of the scent fluid has escaped.
33. The operator then proceeds in the same manner to locate and remove the second sac.
FIG. 3. SAC COMPLETELY WITHDRAWN.
- A—Scent sac
- B—Muscular Envelope
- C—Discharge Duct
- D—Discharge Papilla
- E—Vent (Rectum)
- F—Wall of Rectum
- G—Cut to Sever Duct
- H—Incision to Expose Sac
- I—Rectum
- J—Tail
34. The incisions should be wiped out with a piece of cloth with carbolic solution and never need any further attention. In a few days not even the scars can be found.