L19: Basic Repro Tract Surgery - LA (Freeman) Flashcards Preview

Surgery (Spring 2015) > L19: Basic Repro Tract Surgery - LA (Freeman) > Flashcards

Flashcards in L19: Basic Repro Tract Surgery - LA (Freeman) Deck (20):
1

advantages/disadv. of standing castration

-inexpensive
-fast
-avoids anesthesia
-uncomfortable
-not recommended in mules, donkeys, ponies, AMH
-uses emasculator
-stifle can contaminate your instrument

2

adv/disadv. of recumbent castration

-IV anesthesia
-better access
-time consuming
-safer for surgeon

3

"open" castration refers to:**

the initial incision
-incises skin and vaginal tunic (closed incises skin only)

4

adv./disadv. of closed castration

-can remove a lot of tissue which is likely to swell
-may not get good hemostatic effect from emasculator

5

castration aftercare

-walking exercise at least 2x daily to reduce swelling
-hydrotherapy optional
-abx and NSAIDs rarely used
-digital opening of incision rarely needed

6

complications of castration

-swelling (edema)
-infection
-hemorrhage
-evisceration (bowel, omentum)
-severe pain
-unaltered behavior
-hydrocele
-urethral transection
-peritonitis

7

cryptorchidism

-abdominal or inguinal
-uni or bilateral
-can have stallion-like behavior due to undescended testicle still producing testosterone

8

dx of cryptorchidism

-Hx/PE/palpation
-rectal exam
-hormonal assay
-human chorionic gonadotropin (HCG) stimulation test

9

fx of gubernaculum

-precedes testicle and brings it down into the scrotum through the vaginal ring

10

penile reefing

-works well for smaller tumors on penis

11

episioplasty ("Caslick's Operation")

-surgically corrects pneumovagina "wind sucking," an age-related condition due to poor perineal conformation (can carry into the uterus); feces can drop into vulva
-suture upper level of vulva
-combined w/ other treatments for: urine pooling, perineal injuries

12

3rd degree perineal laceration

-rectovaginal laceration: jx b/w rectum and vagina completely torn
-rectovaginal fistula: jx b/w rectum and vagina incompletely torn

13

risk factors for perineal lacerations

-first foal
-unassisted delivery
-often lose foal b/c foal gets stuck, or get infected uterus

14

repair of 3rd degree perineal laceration

-NOT an emergency repair!
-wait 30d for swelling to go down, THEN repair
-recreate tear then suture them from side to side using large bites in submucosa
-give epidural

15

Ovariectomy

-to remove a granulosa cell tumor or to castrate a "normal" mare (poor behavior, jump mare)
-granulosa-theca cell tumors can cause abnormal behavior: stallion-like, erratic or no estrus, infertility

16

dx of granulosa-theca cell tumors

Rectal exam: large ovary, small contralateral ovary, absence of ovulation fossa
-U/S, elevated(?) inhibin

17

approaches for ovariectomy

laparoscopy (most common)
flank
oblique paramedia
ventral midline
*hemorrhage a complication of all approaches*

18

approaches to consider BEFORE performing C-section

assisted vaginal delivery
controlled vaginal delivery
fetotomy

19

complications of C-section

-must be completed w/n 90 mins. to save foal
-hemorrhage from uterine incision

20

controlled vaginal delivery (wiki)

"If resolution of the dystocia seems challenging or not possible in the standing mare because of the mare's straining or the orientation of the fetus, a controlled vaginal delivery should be considered. If general anesthesia and a controlled vaginal delivery are likely, epidural anesthesia should not be done. The mare's hindquarters are hoisted to allow the GI tract to move cranially in the abdomen, providing space to more readily perform fetal manipulations."