Operative note 16 Core
Hydrocele repair
What it does: fix a fluid sac round the testis.
Jaboulay, default
- Cut over the tense sac, through skin and dartos. Diathermy as you go.
- Deliver the testis in its tunica.
- Open the tunica away from the testis. Drain.
- Big thick sac: trim the excess tunica. Protect the cord.
- Evert the tunica round the testis.
- Continuous suture behind the testis and cord.
- Not tight round the cord: a little finger must pass along the cord into the everted tunica.
- Diathermy. Haemostasis. Bone dry.
- Testis back, cord untwisted. Close dartos, then skin. Scrotal support.
Lord's, the alternative for thin sacs
- Open the sac. Drain. Deliver the testis. Little dissection.
- Ring of 3/0 bites, 1 cm apart, edge to centre.
- Tie them all. The sac concertinas behind.
From the UroRef Operative Quick Guide.