Once the surgeon makes the tiny incision in the front of the scrotum, he goes looking for one of the two tubes which ordinarily transfers semen from the testicles.
There's only a mild discomfort (2/10 rating) as he looks around, and a slight tugging feeling as he guides it towards the opening of the incision.
The tubes are white, and 3 or 4 millimetres thick. You can just see one in the top photo.
Since the surgeon (A) does not use a scalpel and (B) even if he did, it would be too large to fit through the incision cut into the scrotum, he has to bring the tube out through the incision. The surgeon is just starting to do this in the bottom photo.
This part of the procedure reminds me of opening the proverbial can of worms, and I'd imagine it looks like it too.
Now, from here on in, things get a little more gruesome.