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This modification differs from the original only in the skin incision, evacuation of the contents of the sac, and delivery of the testicle. Some time ago it occurred to me that an incision beginning over the cord, near the spine of the pubis, extending outward and upward along the ligamentum inguinale, might have certain advantages over the usual anterior scrotal incision of the older operations:
With this procedure it is not necessary to hold the scrotum in the gloved hand in order to draw the skin tense over the hydrocele while making the skin incision. Since, because of its very nature, the scrotal tissue is difficult to sterilize properly, this lessens the liability of infection. Some infected wounds of scrotal tissue heal readily; some do not. If the incision is made in such a manner as not to involve the scrotal tissue, the convalescence may be more rapid.
Gann D. A MODIFICATION OF ANDREW'S BOTTLE OPERATION FOR HYDROCELE. JAMA. 1919;73(18):1359. doi:10.1001/jama.1919.26120440001014
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