Celiotomy

Question 1

Definition: Celiotomy

Answer 1

Surgical incision into the abdominal cavity

[Laparotomy is a flank approach; used interchangeably]

Question 2

When would an emergency laparotomy be indicated?

Answer 2

1. uncontrollable hemorrhage [HSA]
2. GDV
3. Perforated GIT
4. Bile peritonitis

Question 3

When prepping your patient for an [exploratory] celiotomy, how far should you clip?

Answer 3

Beyond xiphoid and caudal to cranial pubis area

Question 4

During an exploratory celiotomy, the patient should be position in _____ recumbency.

Answer 4

dorsal

Question 5

What does Gossypiboma mean?

Answer 5

Retained foreign object during surgery (such as a sponge or instrument)

Question 6

What surgical approach is ideal for a celiotomy?

Answer 6

Ventral midline

Question 7

What approach would allow you to make an incision directly over a unilateral cryptorchid testical in the inguinal area?

Answer 7

Paramedian

Question 8

This approach is caudal to the last rib and provides more access to cranial structures (liver, spleen, etc.)

Answer 8

Paracostal

Question 9

What dorsal organs can be accessed via the flank approach?

Answer 9

kidneys, adrenals, ovaries

Question 10

What landmark is used to visualize the linea alba?

Answer 10

umbilicus

Question 11

When making your stab incision for the ventral midline approach, the incision should be made in a ____ direction if using a scalpel and a ____ if using scissors.

Answer 11

scalpel–cranial

scissors–caudal

Question 12

T/F:

If no gross lesions are observed, biopsies are unnecessary.

Answer 12

False

Question 13

What is the #1 reason for rupture of a ureter?

Answer 13

iatrogenic–accidentally clap during spay

Question 14

What 3 things are critical to do before closing the abdominal cavity?

Answer 14

1. check for hemorrhage
2. sponge/instrument count
3. Lavage abdomen

[may wording for this question isn’t great but I remember him putting a lot of emphasis on this slide]

Question 15

What structures are in the cranial quadrant of the abdominal cavity?

Answer 15

diaphragm, 
stomach, 
gall bladder, 
liver
left limb of pancreas

Question 16

In which quadrant is the duodenum located?

Answer 16

right

Question 17

The prostate and bladder are located in which quadrant?

Answer 17

Caudal

Question 18

Which quadrant is the spleen located in?

Answer 18

left

Question 19

Which ligament(s) of the bladder can be removed? Which should be avoided?

Answer 19

Ventral ligament can be removed.

lateral should be avoided.

Question 20

What is the holding layer of abdominal wall?

Answer 20

External rectus sheath

Question 21

Which suture pattern(s) can be used to close the external rectus sheath?

Answer 21

simple interrupted & simple continuous

[same for SC closure]

Question 22

What 4 suture types should be avoided when closing the abdominal cavity?

Answer 22

1. Chromic gut
2. Silk
3. Vicryl rapid
4. Polymerized caprolactam

Question 23

What’s the purpose of subcutaneous tissue closure? (2)

Answer 23

1. decrease dead space

2. better apposition

Question 24

Why would we avoid closing the the SC tissue in a cat?

Answer 24

The SC in cats tends to be inflammatory. They also have v little SC which serves as a source of granulation tissue–if you disrupt this, you delay healing.

Question 25

This pattern may be used as an alternative to SC closure in patients that have very little SC

Answer 25

Intradermal pattern

Question 26

SC closure: After tying to the loop, what technique involves taking a deep SC bite and bringing the needle out through the skin? What does this technique accomplish?

Answer 26

Smurfing the knot,

it inverts the knot deeper