Ligation/neutering

Question 1

What is the technically name for the process of neutering of male animals?

Answer 1

Orchidectomy

Question 2

What does an ovarioectomy or ovariohysterectomy refer to?

Answer 2

Neutering of female animals

Question 3

What are the advantages of performing a flank cat spay?

Answer 3

Fast procedure - limits duration of anaesthesia

Short convalescence period

Question 4

What are the potential disadvantages of a flank spay in a cat?

Answer 4

If there any surgical problems, then the incision must be closed and procedure converted to midline access

Question 5

What are the two kinds of spay possible in a cat?

Answer 5

Flank spay

Ventral midline spay

Question 6

What is the benefit associated with ventral midline access in a cat spay?

Answer 6

Achieves full access to abdomen therefore making it far more straightforward to deal with complications

Question 7

What is the disadvantage of performing a midline cat spay?

Answer 7

Procedure is slightly slower - increases anaesthesia duration
Longer convalescence period

Question 8

What are the relevant features of anatomy to consider when performing a spay?

Answer 8

Uterus
2x ovaries 
2x uterine bodies
1x uterine horn
1x cervix

Question 9

How many ligaments attach the two ovaries to the dorsal body wall? What are they?

Answer 9

2 ligaments: suspensory

ovarian

Question 10

What other anatomy has to be considered within the peritoneal cavity?

Answer 10

Bladder
Small intestine
Colon

Question 11

What anatomical features should be easily identifiable via a ventral midline incision?

Answer 11

Small intestine
Bladder
Colon

Question 12

How should the uterus be accessed?

Answer 12

By displacing bladder caudally, and small intestine cranially

Question 13

How does the uterus sit?

Answer 13

Ventral to colon and dorsal to bladder

Question 14

Which surgical instrument should be avoided when locating uterine horns and why?

Answer 14

DON’T use tissue forceps - these are likely to puncture hollow abdominal organs

Question 15

What organ should be exteriorised first?

Answer 15

First ovary

Question 16

Which technique is used for ligating ovarian/suspensory ligaments?

Answer 16

3 clamp technique

Question 17

What must be done following incision of ligament?

Answer 17

Firmly grip ovarian pedicle using tissue forceps, release bottom lamp to check ligature is sufficiently tight before releasing it into abdominal cavity

Question 18

What happens following excision of ovarian/suspensory ligaments?

Answer 18

Uterine horns are pulled caudally to expose cervix

Question 19

How many clamps are used for ligating cervix?

Answer 19

2

Question 20

What is the preferable method for ligating cervix?

Answer 20

Transfixion ligature

Question 21

Following ligation of cervix, what checks should be performed?

Answer 21

Check that both ovaries have been removed in their entirety

Check that cervical stump is sufficiently ligatured

Question 22

What is the main difficulty to negotiate with the flank spay approach?

Answer 22

Technique does not permit good visibility of the anatomy

Question 23

Where should L uterine horn be in relation to incision?

Answer 23

Horn should lie immediately below lateral abdominal wall incision

Question 24

What problem must be taken into consideration when performing a flank cat spay?

Answer 24

If you lose hold of the severed ovarian pedicle before you’ve checked for bleeding, you’ll have to close flank incision and perform a ventral midline incision to correct the problem

Question 25

How many kinds of ligatures are there? What are these?

Answer 25

3

Circumferential; Halstead transfixed; Modified transfixed

Question 26

Describe a circumferential ligature.

Answer 26

1/2 simple interrupted ligatures tied around a vessel

Requires a sufficient pedicle to prevent ligature from rolling off end

Question 27

How can a circumferential ligature be made more secure?

Answer 27

Performing ligation within a groove created by artery forceps = 3 clamp technique

Question 28

What is the name of the ligating procedure that makes use of artery forceps

Answer 28

3 clamp (circumferential) technique

Question 29

How is a Halstead transfixed ligature executed?

Answer 29

Vessel wall is pierced by suture material, ends crossed over and securing throws made around opposite side of vessel

Question 30

What feature does a Halstead transfixed ligature lack?

Answer 30

No initial securing throws

Question 31

What is the benefit of using a Halstead transfixion ligament?

Answer 31

More secure than a circumferential ligature

Question 32

What is the drawback of using Halstead transfixed ligatures?

Answer 32

Can only be used with fine suture material

Question 33

Describe method of Modified transfixed ligament.

Answer 33

Suture material is threaded through vessel wall, initial throws performed external to vessel, then material looped around and further securing throws added

Question 34

What advantage does Modified transfixed ligament have to offer?

Answer 34

Permits use of thicker suture material for ligation