Celiotomy/Cystotmy Flashcards
Any Surgical Incision into the Abdominal Cavity
Celiotomy
*Celiotomy and Laparotomy are Commonly used Interchangably
Patient Preparation for a _____ Procedure
Celiotomy
*Dorsal Recumbancy
Retained Foreign Object During Surgery (Primarily Gauze)
Gossypiboma
*Make sure to do an Instrument and Sponge Count after every Surgery prior to Closing
Most Common Surgical Approach when Performing a Celiotomy
Ventral Midline
*Most Common approach for Celiotomy Incisions- Usually extended from Xyphoid to Pubis
Celiotomy Surgical Approach that Aims to Incise through Linea Alba
Ventral Midline Approach
*AVOID Rectus Abdominis muscle
When Making the Stab Incision for a Ventral Midline Approach for an Exploratory Celiotomy:
_____ If Using Scalpel and Groove Director
_____ if using Scissors
Cranial- Using Scalpel And Groove Director
Caudal- Using Scissors
*If you make a Caudal Stab Incision- Use Scissors to extend the Incision Cranially
If you make a Cranial Stab incision- Follow Incision Caudally with Scalpel
True/False: When performing an Exploratory Celiotomy you need to be Maticulous and Explore Everything/Everytime
True
*Start at one Quadrant to move to all other quadrants until you have Thoroughly Explored the entire Abdominal Cavity
*Even if No Gross Lesions, Biopsies are ALMOST ALWAYS Indicated
What Structures are Found within the Cranial Quadrant during a Celiotomy
Diaphragm
Stomach
Gall Bladder and Liver
Pancreas
What Structures are Found within the Right Quadrant during a Celiotomy
Duodenum
Right Kidney
Ureter
Right Adrenal Gland
What Structures are Found within the Left Quadrant during a Celiotomy
Descending Colon
Left Adrenal Gland
Left Uterine Horn
Spleen
What Structures are Found within the Central Quadrant during a Celiotomy
Cecum
Jejunum
Mesentary/Mesenteric Lymph Nodes
Ascending Colon
What Structures are Found within the Caudal Quadrant during a Celiotomy
Duodenocolic Ligament
Bladder
Prostate
Uterine Body
Best Grip used during Surgical Approach for Cystotomy
Fingertip Grip
*Best Accuracy and Stability for Long Incisions
Why Do we Place Laparotomy Sponges around the Bladder when Performing a Cystotomy?
Prevent Urine Leakage into the Abdominal Cavity
*When we make an Incision into a Normal Bladder we will get Urine Leakage. Urine can be very Irritating to the Abdominal Wall and other Abdominal Structures
Best Suturing Technique used on the Bladder when Performing a Cystotomy
First Layer- Simple Continuous
Second Layer- Inverting Pattern (Cushing or Lembert)
*Need a Watertight Closure
True/False: Biopsies are Often Performed during Exploratory Laparotomies/Celiotomies
True
*Biopsies are Often Performed during Exploratory Celiotomies. Multiple Tissues are Biopsied based on Suspected Pathological Process
Two methods for Biopsies during Exploratory Celiotomy
Needle Core (aka True Cut Biopsy)- Sharp Needle Placed onto the Tissue which Retracts portion of Tissue
Incisional- Cutting out a Small Piece and then Closing Defect
Prior to Closure during Celiotomy, Perform a Sponge Count and ____ the Abdomen with Copious Amounts of Warm Sterile Saline
Lavage
*Use large amounts of Warm Saline and Suction the Fluid out in order to Dilute and possible Contamination
Warm Saline can Help to prevent Hypothermia in Patients
When Closing the Abdomen after a Celiotomy we perform a ____ Layer Closure
Three
Holding Layer when Closing a Celiotomy/Laparotomy
External Rectus Fascia
*KNOW THIS- You need to Engage the External Rectus Fascia
Suture Types used when Closing a Celiotomy/Laparotomy
Monofilament Absorbable (PDS)
Multifilament Absorbable
Monofilament Non-Absorbable (Stainless Steel Wire, Nylon)
*All of these Suture Types are Acceptable to use when Closing the Abdomen after performing a Celiotomy
Name Four Suture Types that should be AVOIDED when Closing after Celiotomy/Laparotomy
Chromic Gut- Very Reactive, Absorbs Rapidly
Silk- Very Reactive
Vicryl Rapid- Absorbs Rapidly
Polymerized Caprolactam
After Performing a Celiotomy, when Closing the Fascia you want to take ____mm Bites from the cut edge and you want the Bites ___mm Apart
5mm
Suture Pattern Commonly used to Close the Subcutaneous Tissue after a Celiotomy
Simple Continuous
Suture Pattern that Can be used in Patients with Little Subcutaneous Tissue where the Bites are Taken Parallel at the Base of the Dermis as a Continous Pattern
Intradermal Pattern
*Used as an Alternative to Subcutaneous Closure in Patients with Little Subcutaneous Tissue
Technique used when Closing the Subcutaneous Tissue after Performing a Celiotomy Described Below:
Minimizes the Chance of Suture Tags or Knots being Exposed through Skin
Burying the Knot
*Take first Bite Deep to Superficial, come across and go Superficial to Deep and Tie the Knot
When Ending the Pattern you want a Deep Loop (Last Bite will be from Superficial to Deep) to Tie the Knot onto
When Placing Skin Sutures after a Celiotomy, use an Appositional Pattern taking ____mm Bites from Incision Edge and Avoiding Underlying Tissue
5mm
Common Suture Types and Suture Patterns used to Close the Skin following a Celiotomy
Suture Patterns: Simple Interrupted, Simple Continuous, Cruciate, Ford Interlocking
Suture Types: Monofilament Absorbable or Non Absorbable
