Revision sheet

Radical inguinal orchidectomy

19 steps, each one the authored title and caption from the interactive animation, with the frame captured from that step. Read it before the case, or print it and work through the steps in order.

Teaching only, not for diagnosis or treatment decisions. The text on this sheet is the animation's own step copy, reproduced verbatim.

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UrOops3D · UroRef · © Nity G

  1. 01

    Landmarks and incision line

    Radical inguinal orchidectomy. Step 1: Landmarks and incision line. Captured frame from the interactive animation.
    • Feel the ASIS and the pubic tubercle beside the pubic symphysis.
    • The incision, about 5 cm, lies a finger's breadth above and parallel to the inguinal ligament, along the line of the inguinal canal, over the internal ring towards the external ring.
    • Not scrotal: a scrotal cut opens a second lymphatic drainage route for the tumour.
  2. 02

    Skin

    Radical inguinal orchidectomy. Step 2: Skin. Captured frame from the interactive animation.
    • The scalpel opens the skin along the marked line in one clean pass, and the edges part.
  3. 03

    Subcutaneous fat (Camper's fascia)

    Radical inguinal orchidectomy. Step 3: Subcutaneous fat (Camper's fascia). Captured frame from the interactive animation.
    • The yellow subcutaneous fat, Camper's fascia, is divided with diathermy in the line of the skin cut; the superficial epigastric vessels crossing it are diathermied or tied.
  4. 04

    Scarpa's fascia

    Radical inguinal orchidectomy. Step 4: Scarpa's fascia. Captured frame from the interactive animation.
    • Deeper, the pale membranous layer, Scarpa's fascia, is picked up and divided in the same line.
  5. 05

    External oblique aponeurosis: stop

    Radical inguinal orchidectomy. Step 5: External oblique aponeurosis: stop. Captured frame from the interactive animation.
    • The shiny external oblique aponeurosis comes into view, its fibres running down and in.
    • Stop here: the superficial layers are done.
  6. 06

    Open the external oblique

    Radical inguinal orchidectomy. Step 6: Open the external oblique. Captured frame from the interactive animation.
    • The external oblique is nicked and opened along its fibres with scissors, down through the external ring, lifting it off the ilioinguinal nerve beneath, to show the spermatic cord in the canal.
  7. 07

    Isolate the ilioinguinal nerve

    Radical inguinal orchidectomy. Step 7: Isolate the ilioinguinal nerve. Captured frame from the interactive animation.
    • The ilioinguinal nerve lies on the cord.
    • It is isolated, lifted off the cord and protected out of the way before anything is clamped or cut.
  8. 08

    Clamp across the cord at the internal ring

    Radical inguinal orchidectomy. Step 8: Clamp across the cord at the internal ring. Captured frame from the interactive animation.
    • The cord is freed from the floor of the canal and traced up to the internal ring, and a clamp goes across it there before the testis is handled: the tumour's venous and lymphatic outflow is controlled first.
  9. 09

    Evert the scrotum, deliver the testis

    Radical inguinal orchidectomy. Step 9: Evert the scrotum, deliver the testis. Captured frame from the interactive animation.
    • A finger everts the scrotum from below and the testis is delivered into the wound whole, inside its coverings.
    • The gubernaculum is divided and its vessels diathermied or tied; the scrotum is checked dry.
  10. 10

    Second clamp

    Radical inguinal orchidectomy. Step 10: Second clamp. Captured frame from the interactive animation.
    • With the testis held up out of the wound, a second clamp goes across the cord just above the first, on the testis side.
    • From here, top means towards the testis and bottom means towards the internal ring.
  11. 11

    Divide above both clamps

    Radical inguinal orchidectomy. Step 11: Divide above both clamps. Captured frame from the interactive animation.
    • The cord is divided above both clamps, on the testis side.
    • The testis and cord are the specimen; both clamps stay on the cord stump.
  12. 12

    Transfixion suture between the clamps

    Radical inguinal orchidectomy. Step 12: Transfixion suture between the clamps. Captured frame from the interactive animation.
    • A transfixion suture (0 Vicryl) is passed through the cord and tied below the top clamp, between both clamps.
  13. 13

    Remove the top clamp slowly

    Radical inguinal orchidectomy. Step 13: Remove the top clamp slowly. Captured frame from the interactive animation.
    • The top clamp is released slowly and lifted off, watching the stump: it stays dry.
  14. 14

    Transfixion suture below the bottom clamp

    Radical inguinal orchidectomy. Step 14: Transfixion suture below the bottom clamp. Captured frame from the interactive animation.
    • A second transfixion suture, non-absorbable and left long, is placed and tied below the bottom clamp, at the internal ring.
    • The long end marks the stump for any later retroperitoneal lymph node dissection.
  15. 15

    Remove the bottom clamp slowly

    Radical inguinal orchidectomy. Step 15: Remove the bottom clamp slowly. Captured frame from the interactive animation.
    • The bottom clamp is released slowly.
    • The stump is watched until it is dry before it is allowed to settle at the internal ring.
  16. 16

    Prosthesis, if consented

    Radical inguinal orchidectomy. Step 16: Prosthesis, if consented. Captured frame from the interactive animation.
    • When consented, a prosthesis passes down the same inguinal route into the scrotum and is fixed at its base: never through a separate scrotal cut in cancer.
    • Declined now, it can still be offered later.
  17. 17

    Close the external oblique

    Radical inguinal orchidectomy. Step 17: Close the external oblique. Captured frame from the interactive animation.
    • The nerve is laid back and the external oblique is closed with a continuous 2-0 Vicryl, keeping the ilioinguinal nerve out of the suture line.
  18. 18

    Close Scarpa's fascia

    Radical inguinal orchidectomy. Step 18: Close Scarpa's fascia. Captured frame from the interactive animation.
    • Scarpa's fascia is closed with interrupted 3-0 Vicryl.
  19. 19

    Close the skin; specimen to histopathology

    Radical inguinal orchidectomy. Step 19: Close the skin; specimen to histopathology. Captured frame from the interactive animation.
    • Local anaesthetic is infiltrated and the skin is closed with a subcuticular 4-0 Monocryl.
    • The specimen goes whole and orientated, cord margin marked, in a bag, for histopathology.
    • Tumour markers are repeated after surgery; staging CT and the MDT follow.

Derived from OrchidectomyScene.tsx at build time: every step title and caption above is the authored ProcedureDef text, reproduced verbatim, and this page shares its readable-points renderer with the animation itself. 19 of 19 steps have a captured frame.

Text fingerprint 6aba2eee9233ef18. A caption edit without a re-capture fails the production check, so the sheet and the animation cannot drift apart silently.