The next stage is the removal of the sac. The stump of the sac is sutured under the internal oblique. The inguinal (Poupart's) ligament is exposed. The cord is drawn aside and the conjoined tendon sutured to the under surface of the inguinal ligament. The intertitles say that the first suture should include the periosteum of the symphysis pubis, and that one or two sutures above the internal ring may be used to reinforce the ring. The cord is placed in its new position and the aponeurosis of the external oblique closed. The wound is then closed.