Common Surgical Procedures of the Reproductive Tract in Small Animals Flashcards
(27 cards)
What is an ovariohysterectomy? Routes of access?
Removal of ovaries and uterus
Usually performed via ventral midline incision
Can also be performed via flank incision (cat)
What are the indications for an OVH?
Elective sterilisation Pyometra Ovarian cysts Hydrometra/mucometra Uterine torsion/prolapse/rupture Neoplasia Metritis Improved control of diabetes mellitus/epilepsy
How can you located the uterus and ovaries via the midline approach?
Uterus = push intestines cranially and bladder caudally Ovaries = follow uterine horns
How do you release the ovaries during an OVH?
Break down suspensory ligament
Create window in mesovarium
Describe pedicle clamping during an OVH…
Haemostat using 3 forcep technique
Most proximal forcep removed leaving crush mark
Crush mark makes it easier to ligate
Describe ovarian ligature during an OVH…
Ligate using synthetic absorbable material e.g. vicryl
Leave 0.5cm between ligature and cute edge
Divide between two remaining clamps making sure whole ovary removed
Describe broad ligament ligature during OVH? When is it particularly important?
Ligature using synthetic absorbable material in larger and mature bitches
May not be necessary in immature/small dogs and cats
Particularly important during pyometra, pregnancy, fat due to presence of many vessels
Describe cervical ligatures….
Ligate using synthetic absorbable material e.g. vicryl
Use 3 forcep technique
- Encircling ligature
- Transfixing ligature
Checking pedicles….
- Right ovarian pedicle
- Left ovarian pedicle
- Right broad ligament pedicle
- Left broad ligament pedicle
- Cervical pedicle
- Elevate descending duodenum
- Elevate descending colon
- Elevate descending duodenum/move SI to left
- Elevate descending colon
- Elevate bladder and reflect caudally
Complications associated with OVH?
Haemorrhage Wound breakdown Wound infection Retained swabs Uretral injury Retained ovarian remnant Urinary incontinence Anaesthesia
Surgical variations of OVH?
- Flank spay
- Seen in cats - Ovariectomy
- More logical for routine sterilisation - Laparoscopic technique
- Use vessel sealing device
Indications for caesarean section?
Fetal distress Dystocia due to: - Primary uterine inertia - Secondary uterine inertia - Oversized foetus - Anatomical abnormalities - Foetal monstrosity - Foetal death
Preoperative consideration for small animal caesarian sections…
Electrolytes and other metabolic abnormalities
Owners should be advised on risks to dam and neonate
Anaesthetic considerations with caesarean section…
Regurgitation and aspiration CVRS compromise Depression of neonates Use of good analgesia - Local block Minimise surgery time
How would you carry out a caesarean section?
- Midline approach
- Exteriorise uterus
- Single incision into uterine body and milk foetuses down one by one
- Clamp umbilical cord
- Only remove placentas if come freely
- Uterine repair
- Monocyrl
- Simple appositional
Care of neonates following caesarean section?
Dry and warm
Suction airways
Check for congenital abnormalities
Complications of caesarean section in small animals?
General surgical complications Foetus all removed Post parturient problems - Haemorrhage - Retained placentas - Acute metritis - Subinvolution - Rupture and prolapse of uterus - Milk production issues
Indications for castration…
Population control Behaviour Testicular neoplasia Cryptorchidism Testicular torsion Anal adenoma Perineal rupture Prostatic disease Repair inguinal/scrotal hernia
How do you carry out an open castration?
Ligate using synthetic absorbable material
- Vicryl
- 3 forcep technique
- Encircling or transfixing ligatures
What is the difference between open and closed castrations?
Open
Vaginal tunic cut and not repaired
Closed
Vaginal tunic left intact
Pros and cos:
- Closed reduced risk of intestinal herniation
- Open castration may reduced post-op swelling and reduce the risk of ligature slippage
What is open castration?
Vaginal tunic cut and not repaired
What is closed castration?
Vaginal tunic left intact
Describe castration in a cat…
Clear rather than aseptic procedure Open castration 2 scrotal incisions Ligatures rarely used - Vas deferns and spermatic vessels knotted together
What is scrota ablation?
Removal of scrotum as well as testes
