Abdominal Exploratory

Question 1

Obj: Discuss the key steps and landmarks for entering and closing the abdomen in a small animal patient. Including suture sizes and types.

Question 2

Obj: discuss if an abdominal exploratory is indicated and appropriate timing of the procedure

Question 3

Obj: Be able to recognize the normal location and appearance of abdominal organs and what can be done if abnormalities are noted during an abdominal exploratory

Question 4

Obj: given multiple procedures, determine a rational order in which to perform them in a patient

Question 5

Obj: Recognize and correct common mistakes made during abdominal exploratory (including approach and closure)

Question 6

How is the abdominal incision closed?

Answer 6

• Three layer closure
  
  • Body wall
  • Subcutaneous tissue
  • Skin

Question 7

What size suture should be used to close the body wall?

Answer 7

Question 8

What can be biopsied during an exploratory

Answer 8

• Easy:
  
  • Stomach
  • Small intestine
  • liver
  • bladder
• Medium
  
  • Spleen
  • Pancreas
  • Colon
  • Lymph nodes
• Hard:
  
  • Kidney
  • Prostate
    
    • Vascular
• Impossible:
  
  • Adrenal
  • Ureter
  • Biliary tree

Question 9

In what order should multiple surgeries be performed on a single patient?

Answer 9

• More critical to less critical
• less contaminated to more contaminated
• Most important to least important

Question 10

What is Cossypiboma?

Answer 10

retained surgical sponge

Question 11

How can gossypiboma prevented?

Answer 11

• Count sponges before opening and before closing
• Radio-opaque gauze
• 4x4s in abdomen only on forceps or in hand
• Use laparotomy sponges for packing of abdomen