Common surgical procedures of the reproductive tract in the dog and cat Flashcards
How do you locate the uterus for OVH?
Push intestines cranially and bladder caudally. Locate ovaries by following uterine horns
What is ovarian release?
In OVH, the ovaries can be released by breaking down the suspensory ligament (cut>tear), create window in mesovarium.
How do you do pedicle clamping in OVH?
Haemostasis using 3 artery forceps (either 3 dorsal to ovary OR 2 dorsal and 1 ventral)
What should you use to do an ovarian ligature?
SYNTHETIC ABSORBABLE MATERIAL:
Vicryl
One/two/instrument tie
Encircling ligature/figure of 8
Why must ovarian ligature be tight?
Ovarian a arises from aorta. Reduce risk of slippage by leaving 0.5cm between ligature and cut edge.
What should you use for a broad ligament ligature?
Synthetic absorbable material cases in all cases except very immature/ small dogs and cats (Vicryl ideal)
What should you use for a cervical ligature?
Synthetic absorbable material (Vicryl)
3 forcep technqiue
EITHER: encircling ligature, transfixing ligature, stick ties
How do you check the right ovarian pedicle?
Elevate descending duodenum
How do you check the left ovarian pedicle?
elevate descending colon
How do you check the right broad ligament pedicle?
elevate descending duodenum/ more SI to left
How do you check left broad ligament pedicle?
elevate descending colon
How do you check the cervical pedicle?
elevate bladder and reflect caudally
Complications of OVH?
GENERAL - wound breakdown, infection, haemorrhage, retained swab
SPECIFIC - ureteral injury, retained ovarian remnant
OTHER - SMI, weight gain, anaesthetic complications
What variations are there in the technique to perform an OVH?
FLANK SPAY - usually L flank, care with oriental cats and the regrowth of their fur (darker)
OVARIECTOMY VERSUS OVH - latter commoner in UK, ovariectomy used in many EU countries routinely, more logical for elective sterilisation but not appropriate for management of uterine disease
LAPAROSCOPIC DISEASE - ovariectomy with a vessel sealing device (i.e. no ligature), gaining popularity, quicker recovery but high capital cost to set up
How common are c-sections?
64% dogs with dystocia treated this way
80% cats with dystocia treated this way
Base decision based on dam, foetuses and owner