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RUSVM Surgery LAB > OHE > Flashcards

Flashcards in OHE Deck (25):
1

Indications for OHE?

Elective sterilization
Treatment of ovarian neoplasia
Treatment/prevention of uterine disese (pyometra/torsion)
Prevention/treatment of vaginal hyperplasia/prolapse
Prevention of mammary neoplasia

2

What additional advantages can OHE have for a pet, in addition to preventing the babies?

Prevention of mammary tumors

Possibly prevent
-idiopathic epilespy (estrogens)
-diabetes mellitus (progesterone inhibits insulin receptors)

3

What are disadvantages of OHE?

Obesity
-increased appetite and decreased metabolic rate

Orthopedic problems
-hip dysplasia/CCL rupture

Urinary incontinece
-20% of spayed females
-estrogen plays a role in sphincter

Neoplasia
-HSA
-lymphoma

4

What approach do you use for OHE?

Ventral midline

From umbilicus to pubis

5

After you incise the skin and SQ, you want to remove SQ from fascia, how much do you remove and how?

Blunt dissection with metzenbaum scissors

Lift 5mm (too much dead space can lead to seroma)

6

How do you make your incision into the linea alba?

Tent abdomen

Reverse stab incision
45degree angle

Carinal if using scalpel
Caudal if using scissors

7

Where are the ovaries and the uterine horns located?

Ovaries at caudal pole of kidney
Uterine horse run in dorsolateral abdomen

Uterine body is between bladder and colon

8

What spans between the ovary and uterine horns and is should be clamped to manipulate ovary

Proper ligament

9

What runs betwee the cranial pole of the ovary to the body wall/last rib and must be broken to exteriorize the ovary ?

Suspensory ligament

10

How is he suspensory ligament broken?

Hold clap, ovary and uterine horse

Apply gentle traction

Isolate suspensory ligament
Rupture towards insertion

11

What vessels supply the ovary?

Ovarian arteries branch off aorta
Anastomosis with uterine artery’s

Right ovarian vein —> vena cava
Left ovarian vein —> left renal vein

12

You need to make a window in the broad ligament before placing your ligatures.. where will you make this window?

Avascular area of mesovarium (window make with Rochester-carmalts)

13

What technique is this?
Clamp on the proper ligament and two on the pedicle

Modified 3 clap technique

14

What type of ligature do you place in the modified 3 clap technique and where should it be placed?

Millers knot in the crush of the most proximal clamp

15

What size suture do you use for ovarian pedicle ligation?

2/0 for most

3/0 - for toy breeds and cats

0- for giant breeds

16

How is the uterine body ligated?

3 clap technique
-millers in crush of most proximal clamp

Transfixing ligature proximal to middle clamp

17

How can you check your ovarian pedicle for hemorrhage?

Left — move mesocolon medially

Right — medoduodenum medially

18

How can you check the uterine stump for hemorrhage?

Located between colon and bladder
Exteriorize bladder can help

19

Common complications to OHE?

Hemorrhage
- tearing of pedicle while strumming
-incomplete ligation
-loose ligatures
- increased risk in dogs >25kg

Infection
Dehiscence
Ligation or clamping of ureter

20

How do you recognize hemorrhage post op?

Signs of shock
- slow recovery
-pale membrane
- distended abdomen
-decreased BP

this should NEVER happen

21

What do you do if you see hemorrhage during your OHE?

Extend the incision

Laparotomy sponges to tamponade area

Identify source of bleeding

Exteriorize vessel before clamping
Clap and re-ligate

22

What post op care is required for OHE patients?

Exercise restriction

Elizabethan collar

Dogs in estrus
— males may still try to mate early post op (make sure to separate) —> can cause terrine tearing

23

How does the approach to feline OHE differ from dog?

Feline: Middle 1/3 of caudal abdomen and usually a shorter incision (3-4cm)

Dog: cranial 1/3 of caudal abdomen , incision 4-6cm

24

T/F: the suspensory ligament must be broken to exteriorize the ovary in cats

False

25

How is our uterine body ligation different in cats compared to dogs?

Dogs: 3 clamp technique

Cat: double ligate before clamping (2 clamps distal to ligature then transection )