What are the steps for hydrocele surgery?

Testicular hydrocele is a relatively common symptom. The secretion of fluid in the tunica vaginalis is actually normal, but when the absorption is reduced, testicular hydrocele may occur. Generally, the effusion will gradually disappear during the development process and does not require too much attention. However, if the amount of effusion is large, surgery may be required to remove it. The general procedure for hydrocele surgery is that the patient lies in a supine position, and the doctor then cuts the levator fascia. This process depends on the extent of the fluid accumulation. Let’s take a look at the specific steps below!

The tunica vaginalis, which is derived from the peritoneum of the process vaginalis when the testicle descends, has a secretory function. The serosal surface of the tunica vaginalis can secrete fluid, which can be absorbed at a constant rate through the spermatic vein and lymphatic system. When the secretion increases or the absorption decreases, the fluid accumulated in the tunica vaginalis sac exceeds the normal amount and forms a cyst, which is called hydrocele.

Pathologically, testicular hydrocele can be divided into primary hydrocele and secondary hydrocele; clinically, it can be divided into communicating and non-communicating hydrocele. This disease is not difficult to diagnose. It can be diagnosed by ultrasound showing anechoic images or liquid echoes in the scrotum or spermatic cord. Most hospitals use surgery to treat hydrocele, but according to extensive statistics and clinical observations in our hospital, this disease has many complications after surgery. There are two different surgeries for this disease; 1. Complete vaginal excision. two. Sheath inversion.

Most hydroceles can be absorbed by themselves during development, so they are generally not treated unless the effusion is huge. Surgical treatment is suitable for larger hydrocele, while small hydrocele can be treated with cyst puncture, fluid extraction and injection.

The steps of hydrocele surgery described in the hydrocele surgery video are as follows:

1. Lie flat. The anterior wall of the scrotum is incised longitudinally. Its length depends on the size of the hydrocele. Incise the skin and panniculus carnosus.

2. Incise the levator testis fascia and levator testis muscle to reach the sac vaginalis. The sac of the vagina was separated and freed between the levator testis and the parietal layer of the vagina, and the latter appeared transparent.

3. Squeeze the tunica vaginalis out of the scrotal incision: cut the tunica vaginalis and suck out all the sac fluid. Use scissors to expand the incision upward and downward.

4. If the tunica vaginalis sac is not too large, the tunica vaginalis can be flipped behind the testicle and interrupted by suture with fine thread.

5. If the tunica vaginalis sac is large, the excess tunica vaginalis can be cut away without turning it over.

6. The bleeding points on the edge of the sheath should be carefully ligated to stop bleeding, or intestinal thread can be used for continuous suture to stop bleeding.

7. The scrotal incision is sutured in layers with fine silk thread, and the skin is sutured with vertical mattress interrupted sutures. A rubber patch is placed at the lowest part of the incision for drainage.