To see the structures you are working on better, bring the microscope into play.
The inguinal fat pad and surrounding fascia are cut with dissection scissors along the margin of the opened wound. The inguinal fat pad is draped aside and a retractor is placed on the abdominal wall muscles to expose the inguinal ligament. Do not stretch the ligament, as this could cause spasm of the femoral vessels, harm the vessels proximal to it, or obstruct their blood flow, aiding clot formation. Here you see the femoral vessels, accompanied by the femoral nerve, lying in a common sheath. The medial and lateral limits of the dissection are the inguinal ligament, and the intersection of the inferior epigastric vessels with the femoral vessels. The common sheath is opened up all along the exposed femoral vessels. Grasp the tissue overlying the femoral artery with two forceps and tear it open, pulling perpendicular to it. Start at any one point and extend your dissection laterally and medially. To isolate the femoral artery, pick up its adventitia and gently pull the surrounding tissues away from it. Always point the forceps tips towards the artery to minimize risk of puncturing the relatively thin walled vein. To dissect the vessel’s underside, you can use spreading movements as long as you can see the instrument’s tips. Dissect a few millimeters of the collateral vessel on the underside of the artery, as well. Then ligate it right at its origin and distal to it. Cut the collateral with your scissors.