Celiotomy Flashcards
What do you call any surgical incision into the abdominal cavity?
Celiotomy
What do you call a flak approach to the abdominal cavity?
Laparotomy
What are the indications for a celiotomy/laparotomy?
Prophylactic (eg OHE or gastropexy)
Diagnostic (exploratory for neoplasia or biopsy)
Therapeutic (eg cystotomy)
What are indications for an emergency laparotomy?
Uncontrollable hemorrhage
GDV
Perforated GIT
Bile peritonitis
T/F: When preparing a male dog for celiotomy, you should drape the prepuce in the surgical field
False
Should always drape out of surgical field … source of contamination
What do you call a retained foreign object during surgery?
Gossypiboma
— always count and recount gauze!!
What is the most common surgical approach for celiotomy ?
Ventral midline
Cause less hemorrhage and better visualization
Why do we generally want to avoid paramedical approaches to the abdomen?
Goes through muscle tissue and cause excessive bleeding
Also more painful for patient
When would you do a paracostal approach?
Crainial oriented organs like the stomach, liver, or gallbladder
When would you do a flank approach ?
For dorsally located structures — ovary, adrenals, kidney
When doing a ventral midline approach, you should be incising through the ??
Linea alba
- stab incision
—> if cranial, extend caudally with scalpel and groove director
—> if caudal, extend using scissors
The falciform ligaments can be very prominent… how can you deal with this to improve visualization during surgery?
Retract to left for right
Can cauterize and remove with electroscaplel
OR
Ligate and resect
What is in the crainial quadrant of the abdomen?
Diaphragm
Stomach
Liver and gallbladder
Left limb of pancrease
What is in the right quadrant of the abdomen ?
Duodenum and right limb of pancreas
Kidney
Ureter
Adrenal (pheochromocytoma)
What is in the left quadrant of the abdomen?
Descending colon
Spleen
Left…
Kidney
Ureter
Uterine horn
What is located centrally in the abdomen?
Cecum
Jejunum
Mesenteric lymph nodes
Transverse colon
What is located in the caudal quadrant of the abdomen ?
Bladder
Prostate
Uterus
Always before closing the abdomen.. what do you need to assess?
Hemorrhage
Sponge count
Lavage - warm sterile saline, copious amounts,
What is the holding layer in closing the abdomen?
External rectus fascia
What suture patterns can be used in the external rectus fascia and how far should your bites be?
Simple interrupted
Simple continuous
5mm bites
What suture is used in the external rectus fascia ?
Monofilament - polydiosanon or poligelcaperone
Multifilament- polyglycolic acid or polyglactin
Non absorbable - polypropylene, monofilament nylon, stainless steel wire
What suture should you avoid in the external rectus fascia?
Chromic gut
Silk
Vicryl rapid
Polymerized caprolactam
What is the purpose of suturing the SQ ?
Receive dead space
Better skin apposition
What patterns are used in the SQ?
Simple interrupted
Simple continuous
-vertical bites
Do you do SQ tissue closure in cats?
Nope
Cats have very little SQ or dead space
SQ is very inflammatory — suture rxn
How do you do a intradermal (subcuticular) pattern?
Continuous patter
Bites parallel
Base of dermis
Exit and enter directly across
May be alternative to SC closure
Patients with little SC
May not need skin closure
