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Operation for the Cure of Inguinal Hernia in the Dog
118
THE VETERINARY JO URNAL
Operation for the Cure of Inguinal Hernia in the Dog. By R. HUDSON, F.R.C.V.S., R elford. W HE~ castrating of the an imal may bf! carried o ut. thL' t)peratlOlI for the cure of inguinal hernia is a sil1l pie m't tter, hut where the testicles are to be savee! it beco mes a much more difficult ami senous problem.
The subject in this case was a P ek ingese which h<1d W Oll mallY prizes and was valua ble for stud purposes . Therefore, the owner was anxious that the testicles should be aved. To han cast rated him would have rendered him ineligible for Shows. H e was about ] 3 months old a nd .the hernia on one sid e formed a sac of the scrotum about two inches wide by four inches long. and the testicle could only be felt vvith c1 ifficult\·. On the other -iidc the hernia was not observed until some d ~lXS after the pre \·ious side had been operated on, when it was foulld to ti ll out the neck of the sac for about one in ch. It became much worse late r on. Operation No. 1.
It was intene!ed to close t he a bdomin al open ing and to narrow the neck of the sac by sutures, leaving sufficif'nt room for t he spermatic artery and vas deferens. Th e inguina l opening was about threr (juarters of an in ch long and easily admitted mv little li nger. After fasting for 24 hours. the patirnt was g iVf:n one grain of morphia, and when s uf{i c i e ntl~· under its influence was placed on the operating table. The scat of the operation was prepared by washing, shaving, dressing with Tl. Iodine and ahout 20 minims of two and a half per cent. Solution of Cocain inj ected over the inguinal opening. The hernia ha\·ing been red uced an incisi'Jn abo ut Oll e and a ha lf inches long was made over the opening and di ssection ca rrieJ oul unti l the neck of the sac was e,posed, fat and connect ive tissu(' being removed. The wall ot the sac was very thin , the spermati c artery and vas deferens being clearly seen through it. The edges of the abdomin a l openin g were very thin and iU -defined and to infold the wall of the sac and sutnre the edge of the nng presented considerable difficulty. fIltestine. kept falling into the saC' and they, along with
thl'
CU RE OF
INGUI~AL
HERNIA
119
sl~rmatic
artery a nd vas deferens, were always in rlanger of being induded in the sutures . Howc \·er , T managed to place five or six sutures and hoped for the I)('st. The cavity was swabbed out , the skin sutured and a dressing applied unde r a bandage. On the fourth day the wound ", as found to be suppurating and some sutures wpre removed , the ca\·ity being swabbed out and lightly packed; also, the other side was noticed to be bigger than normal in the l1righbourhood of the inguinal ring. In about 10 days th" wound was almos t healed, but a suspicious swelling hegan to appear at the sitr- of ope ra tion, and the swelling on the other idr increaspc1 . . It was evidpnt that th e ope rati on had been a failure. Second Operation.
The wound havin g prartically hraied and the underlying tissues h('come fai rl y elasti c. the pa tient was preparccl as before. I hac! pre"iolls ly sutured the abdominal opening with a small curved needle, whi ch was cliffi cuJt to handlp. J now had a small McEwan's MedIc which wa much better to guide (l nd work with. On the of)e rated side the nE'ck of the ~ac was difficult to locate owing to newl y-fo rmed tiss ue a nd in the attempt I penetrated it a nd so had troubl e with escapi ng intestines. However. r managed to get m,· sutures into position better than in the fi rst attempt a nd closed th e abdomin al opening more satisfactorily , lea\·in g room for the a rtery a nd vas defe rens. Sutures were also placed a\(JI1g tl1P neck of the sac. The o the r side was operated on in the same way . the only difference being that there was more fat an d ti~sur ove r the inguinal opening. In placing the skin sutures they were ra ni ed throug h underlying tissue whe re possible. The wound ~ we re dressed wit h Iodoform ann Boracic Acid, a nd a pad of wool was held in position by a bannage. The wound,,; healed WIthout suppuration . except a small cavity a t the end of one of them. Thi s did not givE' much trouble. ·Aftrr about a fortnight there was a suspi cious swelling on one side, but the owner was advised to keep the wool a nd banrlage applied fnT three or four weeks and la tely, about three months after the operation . [ hear that t hr pa tient is cured and being used for stud P1IrptlSC:' .
THE VETERINARY JO URNAL
Operation for the Cure of Inguinal Hernia in the Dog. By R. HUDSON, F.R.C.V.S., R elford. W HE~ castrating of the an imal may bf! carried o ut. thL' t)peratlOlI for the cure of inguinal hernia is a sil1l pie m't tter, hut where the testicles are to be savee! it beco mes a much more difficult ami senous problem.
The subject in this case was a P ek ingese which h<1d W Oll mallY prizes and was valua ble for stud purposes . Therefore, the owner was anxious that the testicles should be aved. To han cast rated him would have rendered him ineligible for Shows. H e was about ] 3 months old a nd .the hernia on one sid e formed a sac of the scrotum about two inches wide by four inches long. and the testicle could only be felt vvith c1 ifficult\·. On the other -iidc the hernia was not observed until some d ~lXS after the pre \·ious side had been operated on, when it was foulld to ti ll out the neck of the sac for about one in ch. It became much worse late r on. Operation No. 1.
It was intene!ed to close t he a bdomin al open ing and to narrow the neck of the sac by sutures, leaving sufficif'nt room for t he spermatic artery and vas deferens. Th e inguina l opening was about threr (juarters of an in ch long and easily admitted mv little li nger. After fasting for 24 hours. the patirnt was g iVf:n one grain of morphia, and when s uf{i c i e ntl~· under its influence was placed on the operating table. The scat of the operation was prepared by washing, shaving, dressing with Tl. Iodine and ahout 20 minims of two and a half per cent. Solution of Cocain inj ected over the inguinal opening. The hernia ha\·ing been red uced an incisi'Jn abo ut Oll e and a ha lf inches long was made over the opening and di ssection ca rrieJ oul unti l the neck of the sac was e,posed, fat and connect ive tissu(' being removed. The wall ot the sac was very thin , the spermati c artery and vas deferens being clearly seen through it. The edges of the abdomin a l openin g were very thin and iU -defined and to infold the wall of the sac and sutnre the edge of the nng presented considerable difficulty. fIltestine. kept falling into the saC' and they, along with
thl'
CU RE OF
INGUI~AL
HERNIA
119
sl~rmatic
artery a nd vas deferens, were always in rlanger of being induded in the sutures . Howc \·er , T managed to place five or six sutures and hoped for the I)('st. The cavity was swabbed out , the skin sutured and a dressing applied unde r a bandage. On the fourth day the wound ", as found to be suppurating and some sutures wpre removed , the ca\·ity being swabbed out and lightly packed; also, the other side was noticed to be bigger than normal in the l1righbourhood of the inguinal ring. In about 10 days th" wound was almos t healed, but a suspicious swelling hegan to appear at the sitr- of ope ra tion, and the swelling on the other idr increaspc1 . . It was evidpnt that th e ope rati on had been a failure. Second Operation.
The wound havin g prartically hraied and the underlying tissues h('come fai rl y elasti c. the pa tient was preparccl as before. I hac! pre"iolls ly sutured the abdominal opening with a small curved needle, whi ch was cliffi cuJt to handlp. J now had a small McEwan's MedIc which wa much better to guide (l nd work with. On the of)e rated side the nE'ck of the ~ac was difficult to locate owing to newl y-fo rmed tiss ue a nd in the attempt I penetrated it a nd so had troubl e with escapi ng intestines. However. r managed to get m,· sutures into position better than in the fi rst attempt a nd closed th e abdomin al opening more satisfactorily , lea\·in g room for the a rtery a nd vas defe rens. Sutures were also placed a\(JI1g tl1P neck of the sac. The o the r side was operated on in the same way . the only difference being that there was more fat an d ti~sur ove r the inguinal opening. In placing the skin sutures they were ra ni ed throug h underlying tissue whe re possible. The wound ~ we re dressed wit h Iodoform ann Boracic Acid, a nd a pad of wool was held in position by a bannage. The wound,,; healed WIthout suppuration . except a small cavity a t the end of one of them. Thi s did not givE' much trouble. ·Aftrr about a fortnight there was a suspi cious swelling on one side, but the owner was advised to keep the wool a nd banrlage applied fnT three or four weeks and la tely, about three months after the operation . [ hear that t hr pa tient is cured and being used for stud P1IrptlSC:' .