Celiotomy

Question 1

What do you call any surgical incision into the abdominal cavity?

Answer 1

Celiotomy

Question 2

What do you call a flak approach to the abdominal cavity?

Answer 2

Laparotomy

Question 3

What are the indications for a celiotomy/laparotomy?

Answer 3

Prophylactic (eg OHE or gastropexy)

Diagnostic (exploratory for neoplasia or biopsy)

Therapeutic (eg cystotomy)

Question 4

What are indications for an emergency laparotomy?

Answer 4

Uncontrollable hemorrhage
GDV
Perforated GIT
Bile peritonitis

Question 5

T/F: When preparing a male dog for celiotomy, you should drape the prepuce in the surgical field

Answer 5

False

Should always drape out of surgical field … source of contamination

Question 6

What do you call a retained foreign object during surgery?

Answer 6

Gossypiboma

— always count and recount gauze!!

Question 7

What is the most common surgical approach for celiotomy ?

Answer 7

Ventral midline

Cause less hemorrhage and better visualization

Question 8

Why do we generally want to avoid paramedical approaches to the abdomen?

Answer 8

Goes through muscle tissue and cause excessive bleeding

Also more painful for patient

Question 9

When would you do a paracostal approach?

Answer 9

Crainial oriented organs like the stomach, liver, or gallbladder

Question 10

When would you do a flank approach ?

Answer 10

For dorsally located structures — ovary, adrenals, kidney

Question 11

When doing a ventral midline approach, you should be incising through the ??

Answer 11

Linea alba

• stab incision
  —> if cranial, extend caudally with scalpel and groove director
  —> if caudal, extend using scissors

Question 12

The falciform ligaments can be very prominent… how can you deal with this to improve visualization during surgery?

Answer 12

Retract to left for right

Can cauterize and remove with electroscaplel
OR
Ligate and resect

Question 13

What is in the crainial quadrant of the abdomen?

Answer 13

Diaphragm
Stomach
Liver and gallbladder
Left limb of pancrease

Question 14

What is in the right quadrant of the abdomen ?

Answer 14

Duodenum and right limb of pancreas

Kidney

Ureter

Adrenal (pheochromocytoma)

Question 15

What is in the left quadrant of the abdomen?

Answer 15

Descending colon
Spleen

Left…
Kidney
Ureter
Uterine horn

Question 16

What is located centrally in the abdomen?

Answer 16

Cecum
Jejunum
Mesenteric lymph nodes
Transverse colon

Question 17

What is located in the caudal quadrant of the abdomen ?

Answer 17

Bladder
Prostate
Uterus

Question 18

Always before closing the abdomen.. what do you need to assess?

Answer 18

Hemorrhage

Sponge count

Lavage - warm sterile saline, copious amounts,

Question 19

What is the holding layer in closing the abdomen?

Answer 19

External rectus fascia

Question 20

What suture patterns can be used in the external rectus fascia and how far should your bites be?

Answer 20

Simple interrupted
Simple continuous

5mm bites

Question 21

What suture is used in the external rectus fascia ?

Answer 21

Monofilament - polydiosanon or poligelcaperone

Multifilament- polyglycolic acid or polyglactin

Non absorbable - polypropylene, monofilament nylon, stainless steel wire

Question 22

What suture should you avoid in the external rectus fascia?

Answer 22

Chromic gut
Silk
Vicryl rapid
Polymerized caprolactam

Question 23

What is the purpose of suturing the SQ ?

Answer 23

Receive dead space

Better skin apposition

Question 24

What patterns are used in the SQ?

Answer 24

Simple interrupted
Simple continuous
-vertical bites

Question 25

Do you do SQ tissue closure in cats?

Answer 25

Nope

Cats have very little SQ or dead space
SQ is very inflammatory — suture rxn

Question 26

How do you do a intradermal (subcuticular) pattern?

Answer 26

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