Every procedure requires the patient to stay in a certain position. For a simple orchiectomy, the patient is made to lie in a flat or in medical terms, a supine position on an operating table. The patient is prepped and draped in the usual standard sterile manner. The penis is taped against the abdomen so that the scrotum is exposed. The nurse will shave a small area to prepare the region for an incision.
It is a simple procedure that takes only 30 minutes to be performed. It is done under local or regional anesthesia or epidural anesthesia. An example of a commonly used local anesthetic (LA) is the lidocaine. Epidural anesthesia is given by injecting a needle into a small area of the back so that anesthetic can be injected into the epidural space.
After the anesthetic has been administered, the surgeon makes an incision in the midpoint of the scrotum and cuts through the underlying tissue, going through the skin, subcutaneous tissue, dartos layer, and the tunica vaginalis.
The surgeon removes the testicles, along with all the gubernacular attachments, and parts of the spermatic cord through the incision. All the bleeders are coagulated. The incision is closed with two layers of sutures and covered with a surgical dressing.
If the patient desires, a prosthetic testicle can be inserted before the incision is closed to present an aesthetic outward appearance of a pre-surgical scrotum.