Common Surgical procedures in SA

Question 1

What are some indications for Ovariohysterectomy (OVHE)?

Answer 1

Elective sterilisation, Pyometra, ovarian cysts, Hydrometra/mucometra, Uterine torsion / uterine
prolapse, Uterine rupture, Ovarian / uterine neoplasia, Metritis, Improved control of diabetes mellitus / epilepsy

Question 2

What is the NRCW classification for OVHE?

Answer 2

Clean/contaminated

Question 3

What type of material should be used to ligate the ovarian pedicle in OVH?

Answer 3

Synthetic absorbable e.g. Vicryl (ideal)

Question 4

In which situations would you not ligate the broad ligament? What should you ligate with?

Answer 4

Don’t ligate in very immature or small dogs/cats. Should be done using synthetic absorbable material e.g. Vicryl.

Question 5

How can the cervical ligation be achieved? Which types of ligatures?

Answer 5

Can use encircling (mainly small), transfixing ligatures, or stick ties.

Question 6

How can you check the right ovarian pedicle after OHE?

Answer 6

Elevate descending duodenum

Question 7

How can you check the right broad ligament pedicle after OHE?

Answer 7

Elevate descending duodenum/move SI to left

Question 8

How can you check the left ovarian pedicle after OHE?

Answer 8

Elevate descending colon (move medially)

Question 9

How can you check the left broad ligament pedicle after OHE?

Answer 9

Elevate descending colon

Question 10

What are some potential specific complications of OHE?

Answer 10

Ureteral injury, retained remnants, SMI, weight gain.

Question 11

What are some anaesthetic considerations for C-sections?

Answer 11

Regurg/aspiration, depression of neonates, good analgesia for dam (avoid alpha-2, ketamine and thiobarbiturates), minimise time taken to remove.

Question 12

What material should be used to suture the uterus after C-section? What types of patterns?

Answer 12

Synthetic absorbable (Monocryl ideal), simple appositional or inverting, single or double layer.

Question 13

What is an En Bloc OVH?

Answer 13

Hysterectomy performed before a hysterotomy and before removal of neonates.

Question 14

What are the disadv of an en bloc OVH?

Answer 14

All neonates need resusscitating at once.

Question 15

What are the adv of an en bloc OVH?

Answer 15

Minimises anaesthesia time, minimal contamination, effective population control, no need for second surgery.

Question 16

What are some indications for castration in SA?

Answer 16

Population control, behavioural control, behavioural modification, neoplasia, cryptorchidism, torsion, orchitis, trauma, anal adenoma (dog), perineal rupture (dog), prostatic disease.

Question 17

What is the NRCW classification of castration?

Answer 17

Clean

Question 18

What suture material is used in an open castration?

Answer 18

Synthetic absorbable material is best e.g. Vicryl. Can use encircling or transfixing.

Question 19

What is the difference between open and closed castration?

Answer 19

Open: vaginal tunic cut and not repaired
Closed: vaginal tunic left intact

Question 20

What are the pros of open castration?

Answer 20

Open castration may reduce post operative swelling and reduce the risk of ligature slippage

Question 21

What are the pros of closed castration?

Answer 21

Closed castration reduces risk of intestinal herniation

Question 22

What is scrotal ablation?

Answer 22

Removal of scrotum and testes

Question 23

When is scrotal ablation indicated?

Answer 23

Scrotal disease eg MCT or trauma, Improved cosmesis and complications (bruising and swelling) in mature dogs, As part of scrotal / perineal urethrostomy procedure, When scrotum used as a skin donor site