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After induction of GA and painting draping, the inguinal canal is opened by a small medially placed inguinal incision within transverse crease, dividing external oblique aponeurosis.
The reflected part of the inguinal ligament is exposed and the testicular like structure is searched. The hernial sac along with canalicular testis is lifted out separating it from its gubernacular tail. The hernia sac is dissected free from cord structures, vas deference and testis up to the internal inguinal ring, where it is ligated transfixed. The testis along with its cord structures is dissected retroperitoneally to achieve sufficient length so as to reach within the scrotal sac.
A small transverse incision is made at the bottom of the scrotum just lateral to median raphe, and subdartos pouch is created with sharp dissection in between scrotal skin and dartos muscle. Both inguinal and scrotal incisions are interconnected from within and with the help of forceps, the inguinal testis is pulled out via scrotal incision, keeping the orientation of its vessels with vas and avoiding any twist. The testis is fixed within subdartos pouch. Proper hemostasis is maintained at each step and incisions were closed in layers, applying subcuticular sutures for skin.
MBBS, MS, MCh