Cremaster was opened and the hernia sac was identified on the anteromedial side of the cord. Cord structures were gently teased away from sac using one blade of a DeBakey forceps. Pinching of the vas can cause permanent damage.
The sac was twisted to remove any contents and suture ligated at it's base with 4-0 silk. If there were any question of a contralateral hernia, at this point a 5mm laparoscope inserted through the sac could be used to visualize the opposite deep ring (see laparoscopic contralateral pediatric hernia exploration).
Link to this frame from your Personal Thumbnails page?
Click the "Update" button to save your Notes and Personal Thumbnails.