Ovariohysterectomy Procedure Flashcards

1
Q

What do you use a spay hook for?

A

Introduced into the abdomen with the hook parallel to the body wall

It is then rotated 90 degrees and moved towards the midline

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2
Q

Disadvantages of spay hook?

A

Sometimes GIT structures are hooked and it may be necessary to palpate with a finger

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3
Q

Which ovary is more difficult to exteriorise?

A

The right ovary

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4
Q

Which ligament do you break/ stretch first?

A

The suspensory ligament

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5
Q

What do you create a window in in order to be able to ligate the ovarian pedicle?

A

Window in the mesovarium
Caudal to the ovarian vessels

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6
Q

How do you clamp the ovarian pedicle?

A

Triple clamp with carmalt-rochester forceps

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7
Q

Where do you clamp the ovarian pedicle?

A

Proximal to the ovary (if possible)
otherwise, one clamp between ovary and uterus

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8
Q

Where do you tie into?

A

The crush

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8
Q

What does the selection of suture size depend on?

A

The amount of fat in the pedicle
Your confidence in your ligature

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9
Q

2 types of suture material for ovarian pedicles

A

BOTH ABSORBABLE MONOFILAMENT

PDS (polydioxanone suture)
Polyglyconate

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10
Q

Suture size for ovarian pedicles

A

Dogs 0 - 2/0 - 3/0

Cat 3/0

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11
Q

What to do after you transect the pedicle

A

Hold the pedicle in forceps without tension before releasing into the peritoneal cavity

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12
Q

How to transect the broad ligament (2nd)

A

cut or break with fingers

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13
Q

What do you need to avoid when breaking the broad ligament?

A

The uterine vessels

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14
Q

Extra step in multiparous, pregnant or mature dogs?

A

There may be large branching vessels that require ligation

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15
Q

Uterine body clamps

A

1-2 clamps just cranial to the cervix

16
Q

What is the role of the cervix?

A

Natural barrier to the exterior

17
Q

How much uterine body tissue should be removed?

A

As much uterine tissue as possible to prevent complications such as stump pyometra

18
Q

Type of ligature for uterine body

A

Single, encircling ligature

19
Q

When to use a transfixing ligature for uterine body?

A

If uterus is enlarged
i.e. pregnant or in season

20
Q

How to ligate the uterine vessels?

A

Independent to the uterus

21
Q

What do you need to check the abdominal cavity for?

A

Haemorrhage

22
Q

Linea alba closure material

A

Monofilament, absorbable
PDS (polydioxanone suture)
Polyglyconate
1 - 3/0

23
Q

Skin suture material

A

Non-absorbable
Polypropylene or Nylon or Polyamide

24
Q

Intradermal suture material

A

Absorbabke
PDS or polyglyconate

25
Q

What is the most common ovariohysterectomy complication?

A

Haemorrhage - 76%

26
Q

3 types of wound healing complications

A

Suture reaction (most common in cats)

Seroma (fluid accumulation)

Fistulous tracts (abnormal passage)

27
Q

4 causes of stump pyometra

A

Progesterone produced by remnants of ovarian tissue (or exogenous)

Stump inflammation or granuloma from non-absorbable material

Poor aseptic technique

Excessive residual devitalised uterine body

28
Q

Urogenital complications (2)

A
  1. Accidental ureteral ligation
  2. Urinary incontinence (11-20% of desexed females)
29
Q

How to treat post spay urinary incontinence

A

Stilboestrol or alpha agonists - to increase responsiveness of the smooth muscle of the bladder neck to nerve activity, tightening the muscle and preventing leakage of urine

Colposuspension - when drugs fail - improves pelvic floor and corrects position of the bladder neck to an intra-abdominal position (by cranially stretching the vagina and suturing it to the prepubic tendon on each side of the urethra)

30
Q

In what percentage of patients is weight gain reported ?

A

26 - 38%