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LAS - RUSS > Staplers > Flashcards

Staplers Flashcards

1
Q

5 main kinds of staplers we use:

1.
2.
3.
4.
5.
A
  1. GIA = gastro-intestinal-anastomosis
    aka Intra Luminal Anastomosis (ILA)
  2. TA = Thoracoabdominal
  3. LDS = Ligating-Dividing-Stapler
  4. EEA = End-End-Anastamosis
  5. Skin Stapler
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2
Q

T/F: You can autoclave staplers

A

F, you can’t. Use gas sterilizer if you can.

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3
Q

Average number of times you can re-use staplers?

A

12 times.

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4
Q

Advantages of stainless steel stapler?

A

they can be autoclaved for re-use.

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5
Q

T/F: There are no staplers made specifically for large animals.

A

T. We can use TA 90s if we need to.

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6
Q

GIA Staplers require there are a minimum of how many staple lines?

A

2

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7
Q

TA 90: what does the 90 mean in the name?

A

The staple line is 90 mm (9 cm). It’s the largest one available

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8
Q

T/F: There is no cutting action when using the TA 90

A

True, just crushing. Run a scalpel blade close to the edge of the crushed tissue by hand.

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9
Q

LDS comes in handy because it can perform _______ during what kind of procedure?

A 
isolate blood vessels
bowel resections (where you can see the BVs very easy.
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10
Q

Staples in the LDS: purpose behind mechanism?

A

LDS ligates/crushes the lumen of vessels

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11
Q

Identifying characteristic of EEA stapler?

A

Large wingnut at the end.

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12
Q

What shape staple line does an EEA stapler make?
Diameter of staple line?
How many rows of staple lines?

A

circular
21.2 mm
two

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13
Q

What is a “good night stitch”?

What is the consequence of not putting one in?

A

A stay suture placed via GIA stapler during a bowel anastamosis

The staple line can open up like a zipper

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14
Q

Functional End-To-End Anastamosis of bowel requires using what two staplers?

A

GIA and TA90

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15
Q

Jejunocecostomy is what type of anastamosis?

A

End-to-Side or Side-to-side

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16
Q

What stapler can you use for jejunocecostomy?

A

GIA,

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17
Q

What stapler is most often used for resection of the colon in a horse?

A

TA 90. You’ll need multiple cartridges

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18
Q

What stapler is most often used for creation of a pelvic flexure after colon resection in a horse?

A

GIA

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19
Q

Cecocolon anastamosis - Describe the procedure?

A

make an additional opening between cecum and the large colon using GIA with stab incision, helps the cecum empty easier to avoid impaction.

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20
Q

Equine-cecal resection is usually performed when?

A

When the tip of the cecum goes inside the cecum like an inverting sock, and the cecum starts to auto-digest itself.

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21
Q

What stapler is used for equine-cecal resection?

A

TA90. Staple that part of the cecum off.

22
Q

Broad Causes of Left Displaced Abomasum:

  1. Abomasal ____
  2. decreased ______
  3. _____
  4. Abomasum changes in ___, ___, ____
  5. time periods?
A
  1. Atony
  2. decreased rumen volume
  3. calving
  4. dimensions, position, volume
  5. last 3 months of gestation, first 3 months of lactation
23
Q

4 common causes of abomasal atony that can lead to LDA:

A
  1. increased abomasal VFA
  2. Hypocalcemia
  3. metritis
  4. mastitis
24
Q

Mean incidence of LDA in herds?

A

1-5%, but may exceed 15% in some herds.

25
Q

Clinical symptoms of LDA:

  1. refuse ____
  2. Temp? Defecation?
  3. ____ in left flank
A
  1. refuse grain
  2. normal temp, still passing feces
  3. tympany
26
Q

4 surgical procedures used to correct LDA:

1.
2.
3.
4.

A
  1. Right flank omentopexy
  2. Left flank abomasopex
  3. Right paramedian abomasopexy
  4. closed suture or bar techniques
27
Q

In right paramedian abomasopexy, the animal is in ____ recumbancy.

Sedation (is/is not) required?

A

dorsal

Is! Heavily sedated!

28
Q

Nerve block options for right flank omentopexy:

1.
2.
3.
4.

A
  1. Proximal paravertebral block (T13-L2)
  2. Distal paravertebral block (T12-L2)
  3. Inverted L block
  4. Line block
29
Q

Right flank omentopexy:

Initial incision into ____, located between the ____ and ____.

A

paralumbar fossa between last rib and tubor coxae

30
Q

3 muscle layers you cut through in right flank omentopexy:

A

internal, external and transverse abdominal oblique muscles.

31
Q

Abomasum is supposed to be where, relative to the rumen?

A

ventral to the rumen.

32
Q

Why do you insert a large cannulated needle first into an incision site for a right flank omentopexy?

A

to relieve the gas bubble that has accumulated (it pulls the abomasum more and more dorsally between rumen and bodywall and we need to get rid of that gas)

33
Q

Which of these procedures is performed “blind”?

Right flank omentopexy
or
Left flank celiotomy

A

right flank omentopexy

34
Q

Use what instruements to keep the abomasum in the incision site for a right flank omentopexy?

A

grasping forceps

35
Q

1st part of suturing for right flank omentopexy:

  1. Place (small/large) sutures though the ____, than through the _____.
  2. Suture pattern used?
  3. Immediately after finishing the first suture, you should do what?
A
  1. large
    body wall, then the portion of omentum (sows ear) and out.
  2. Horizontal mattress
  3. do it again in reverse order on the other side.
36
Q

2nd part of suturing for right flank omentopexy:

  1. continue the pattern into the ____.
  2. In a standing cow, you should start suturing (ventrally/dorsally). Why?
A
  1. on the peritoneum

2. ventrally. You want to avoid some of the other bowel spilling out.

37
Q

Other structures to palpate from a right flank celiotomy

  1. 2.
    3.
A
  1. Liver
  2. Left and right kidneys
  3. Urinary bladder
38
Q

What equipment should you have prepared specifically for a left flank abomasopexy?

A

2 straight intestinal needles with 3 feet of suture in-between

39
Q

What suture pattern should you perform on the abomasum in a left flank abomasopexy?

A

simple continuous

40
Q

After suturing at the greater curvature, what broad area do you take the needle to in a left flank abomasopexy?

A

right paramedian area

41
Q

Peforming left flank abomasopexy when in the right paramedian area:

  1. Push needle through ______
  2. Make sure you don’t hit the _____
  3. Direct assistant to do what?
A
  1. abdominal wall
  2. milk vein
  3. push with second needle at the same time as you, but 6 inches caudally.
42
Q

Describe the incision for a right paramedian abomasopexy

  1. length?
  2. location?
A
  1. 20 cm long incision

between midline and right SQ abdominal vein. Incision started 8 cm behind the xiphoid

43
Q

T/F: You will likely have to search around for abomasum after making the initial incision in a right paramedian abomasopexy.

A

F: it will probably be right under your incision b/c it is full of gas

44
Q

In a right paramedian abomasopexy, the (medial/lateral) aspect of the ______ of the abomasum is sutured to the _____

A

lateral

greater curvature

peritoneum

45
Q

Suture technique for right paramedian abomasopexy?

A

3 mattress sutures (along the greater curvature) already in place through entire body wall

46
Q

What method of LDA correction involved “Shaking” to properly replace the abomasum?

A

Closed Suture or Bar Technique

47
Q

With the closed suture or bar technique, the ping should be where if you have properly replaced the abomasum?

A

in the right paramedian area

48
Q

Right sided “ping” indicates….

A

right displaced abomasum

49
Q

RDA simple displacement can be treated ______ or ______

A

medically (via Ca2+/dextrose, or exercise) or surgically

50
Q

In a right sided abomasal displacement, the ping foes from _____ to ____

A

paralumbar fossa to rib 8

LAS - RUSS (32 decks)

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