channe of the prepuce is next slit up, the incision being carried up to the pubic limiting mark. The penis can then be shelled out, the prepuce being first cut through around the corona glandis. If lateral flaps can be formed of sound skin they are then dissected up. The perineal and pubic incisions are now deepened and, assistants holding the testes and penis well out of the way, the neck of the tumour is cut through close to the perineum and pubes. Gaping vessels are all carefully ligatured, redundant tunica vaginalis—if hydroceles be present—being excised. The rubber cord is then removed.
Fig. 122.—Rubber cord in position. (McLeod.)
When hæmorrhage has been controlled, the posterior halves of the flaps are brought together by sutures, the anterior halves being united over the testes to the pubic cut. The penis will therefore emerge from the point where the horizontal line meets the perpendicular line of what is now a T- or Y-shaped wound. If no flaps have been made, the testes may be fixed by stitching any tag of tissue connected with them to the perineum, and the dimensions of the wound reduced as much as possible by stitching up the corners at the pubes and perineum.
In dressing it is of importance that the raw surfaces be covered by some aseptic non-fibrous protective—such as oiled silk—before the antiseptic dressing is
