Randi says the healer would slightly roll or pinch the skin over the area to be treated. When his flattened hand reaches under the roll of skin, it looks and feels as if the practitioner is actually entering into the patient's body. The healer would have prepared in advance small pellets or bags of animal entrails which would be palmed in his hand or hidden beneath the table within easy reach. This organic matter would simulate the "diseased" tissue that the healer would claim to be removing. If the healer wants to simulate bleeding, he might squeeze a bladder of animal blood or an impregnated sponge. If done properly, this procedure may deceive patients and observers. However, some "psychic surgery" procedures do not rely solely on the "sleight of hand" described, as at least one Brazilian "surgeon" also cuts his victims' skin with an unsterilized scalpel to heighten the illusion.