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For the inguinal approach, the bull is anesthetized and placed in lateral recumbency with the affected side up. The upper rear leg must be elevated to expose the inguinal area. The inguinal area is clipped and prepared for aseptic surgery. A 20‐ to 25‐cm incision is made over the inguinal ring (Figure 18.19). The subcutaneous tissues are bluntly and sharply dissected to expose the spermatic cord. An incision is then made in the parietal tunic to expose the herniated tissues (Figure 18.20). The herniated bowel is examined for adhesions or evidence of strangulation. If encountered, strangulated or devitalized bowel should be removed by resection and anastomosis. Adhesions between the bowel and parietal tunic should be ligated before separation [17, 18]. The herniated bowel is then reduced. The decision is made as to whether the testicle on the affected side will be spared or removed. Removing the testicle will prevent postoperative complication that could impact testicular thermoregulation and allows for simplified and complete closure of the inguinal ring.

Figure 18.19 Incision over inguinal ring.

Source: Image courtesy of Darcie Sidelinger and Heath King.

Figure 18.20 Herniated bowel exposed after incising parietal vaginal tunic.

Source: Image courtesy of Richard Hopper.

Closure of the inguinal ring, when the testicle is spared, is accomplished in two stages. The first stage pulls the internal abdominal oblique muscle posteriorly to support and protect the spermatic cord (Figures 18.21 and 18.22). An atraumatic “hernia” needle loaded with #4 non‐absorbable suture is used to take the first bite through the median border of the inguinal ring near the caudal apex of the ring. The suture is passed under the spermatic cord and the second bite is made through the internal abdominal oblique muscle. The suture is then passed back beneath the spermatic cord and through the border of the inguinal ring near the first bite. This procedure is repeated on the opposite side to the spermatic cord, with the initial bite going through the lateral border of the inguinal ring to engage the internal abdominal oblique muscle 3 cm from the first site. Both sutures are then tightened and tied simultaneously, with care taken to not constrict the spermatic cord. An overlapping suture pattern with non‐absorbable suture is used to close the external boarders to the inguinal ring (Figures 18.23 and 18.24). Enough room should be left adjacent to the spermatic cord for two fingers to pass through the inguinal ring. The parietal vaginal tunic is closed with a simple continuous pattern of absorbable suture, and the subcutaneous tissues of the inguinal area are closed to eliminate dead space. The skin is then apposed with a continuous interlocking pattern of non‐absorbable suture [17, 18].

Figure 18.21 Exposure of inguinal ring. MB, Medial border of inguinal ring; LB, lateral border of inguinal ring; SC, spermatic cord.

Source: Image courtesy of Darcie Sidelinger and Heath King.

Figure 18.22 Caudal retraction of internal abdominal oblique (IAO) muscle. MB, Medial border of inguinal ring; LB, lateral border of inguinal ring; SC, spermatic cord.

Source: Image courtesy of Darcie Sidelinger and Heath King.

Figure 18.23 Sutures preplaced through medial and lateral borders of inguinal ring. MB, Medial border of inguinal ring; LB, lateral border of inguinal ring; SC, spermatic cord.

Source: Image courtesy of Darcie Sidelinger and Heath King.

Figure 18.24 Completed closure of inguinal ring.

Source: Image courtesy of Darcie Sidelinger Heath King.

Closure of the inguinal ring following unilateral castration is less complicated. Following ligation and transection of the spermatic cord, the lateral borders of the inguinal ring are closed with a series of preplaced simple interrupted or cruciate sutures. Large non‐absorbable suture can be used or the author has also utilized #4 braided polyglactin for closure. Regardless of the approach chosen, broad‐spectrum antibiotics are administered on the day of surgery and continued for five days. Non‐steroidal anti‐inflammatory drugs are also useful to control postoperative pain and inflammation. Recovery in a small lot versus a stall provides exercise, which helps to reduce postoperative swelling and edema.