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Intro to Surgery > Lecture 19 - Food Animal GI Surgery > Flashcards

Lecture 19 - Food Animal GI Surgery Flashcards

1
Q

What are considerations to take in food animal GI surgery?

A
  1. Large abdominal cavity
  2. Mesenteric, omental attachments
  3. Disease process
  4. Facilities
  5. Temperament
  6. Surgical team experience
  7. Owner financial commitment
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2
Q

What are the main surgical approaches to the food animal abdomen?

A
  1. Paralumbar fossa
  2. Left oblique
  3. Paramedian
  4. Ventral midline
  5. Venrrolateral
  6. Right paracostal
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3
Q

What major structures can be accessed from the left side in a celiotomy?

A

Rumen, gravid uterus

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4
Q

What major structures can be accessed from the right side in a celiotomy?

A

Abomasum, SI, LI (cecum, spiral colon), gravid uterus

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5
Q

What procedures can be done from the left side?

A
  1. Exploratory celiotomy
  2. Rumenotomy/ostomy
  3. LDA
  4. C-section
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6
Q

What procedures can be done from the right side?

A
  1. Exploratory celiotomy
  2. Abomasal disorders
  3. C-section
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7
Q

What steps are taken to prepare the animal for a paralumbar fossa celiotomy?

A

Clip, aseptically prepare, local anesthesia, drape

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8
Q

Where do you want the incision to be in the PL fossa?

A

In the center of the fossa - can adjust for target organ

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9
Q

What layers are you incising through at the level of the PL fossa?

A
  1. Skin
  2. SQ
  3. External abdominal oblique mm
  4. Internal abdominal oblique mm
  5. Transversus abdominis
  6. Peritoneum
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10
Q

How many layers are you going to close in the PL fossa?

A

3-4

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11
Q

What suture material and pattern do you use to close the deep layers of the PL fossa? What direction do you go?

A

Absorbable, simple continuous

Ventral to dorsal

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12
Q

What suture material and pattern do you use to close the skin of the PL fossa? Which direction do you go? How far from the ventral aspect do you end your closure?

A

Non-absorbable, ford interlocking/simple continuous, interrupted ventral

Dorsal to ventral

End closure 3-5 cm from ventral aspect

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13
Q

What structures can be accessed from a ventral midline approach?

A
  1. Abomasum
  2. Reticulum
  3. SI
  4. LI
  5. Urinary bladder
  6. Uterus
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14
Q

What procedures can be done from a ventral midline approach?

A
  1. Exploratory celiotomy
  2. Displaced abomasum
  3. Herniorrhaphy
  4. Omphalectomy/omphalophlebectomy
  5. C-section
  6. Tube cystotomy
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15
Q

What layers are you incising thru in a ventral midline approach?

A

Skin, SQ, linea alba, rectus abdominis, peritoneum

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16
Q

How many layers are included in your closure at ventral midline?

A

3-4

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17
Q

What layers of the body wall do you close in a ventral midline approach? What suture material and pattern do you use?

A

Linea alba, rectus abdominis

Absorbable, simple continuous

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18
Q

What suture material and pattern do you use to close the skin on a ventral midline approach?

A

Non-absorbable, absorbable

Ford interlocking, simple continuous

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19
Q

What organs are accessed with a right paracostal celiotomy?

A

Abomasum, SI, LI

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20
Q

What procedures can be done from a right paracostal approach?

A

Exploratory celiotomy, abomasal disorders

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21
Q

Where, anatomically, is the right paracostal incision made?

A

Parallel and caudal to the last rib

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22
Q

What layers are you incising thru with a right paracostal approach?

A
  1. Skin
  2. SQ
  3. External abdominal oblique mm
  4. Internal abdominal oblique mm
  5. Transversus abdominis
  6. Peritoneum
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23
Q

How many layers are closed in a right paracostal approach?

A

3-4

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24
Q

What layers are closed in the deep closure? What suture material and pattern do you use?

A

Transversus abdominis, peritoneum;

Absorbable, simple continuous

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25
Q

What is the middle layer that is closed in a right paracostal approach? What suture material and pattern do you use?

A

Abdominal oblique muscles;

Absorbable, simple continuous

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26
Q

What suture material and pattern do you use to close the skin on a paracostal approach?

A

Non-absorbable, absorbable;

Ford interlocking, simple continuous

27
Q

Which of Halsted’s principles are important in food animal GI surgery?

A
  1. Gentle handling of tissue
  2. Preservation of blood supply
  3. Strict aseptic technique
  4. Minimize tension on tissues
28
Q

What two things do you want to avoid in FA GI surgery? Why?

A

Handling gentle tissues with fingertips, dry gauze;

Abrades the serosa and promotes adhesion formation

29
Q

How can we best preserve blood supply?

A

Use anatomical and sharp dissection

30
Q

How can we practice strict aseptic technique?

A
  1. Isolate GIT (lap sponges, gravity)
  2. Split table (dirty = enterotomy, clean = laparotomy closure)
  3. Copious lavage
  4. Change barriers
31
Q

What two things are we trying to avoid when we minimize tension on tissue?

A

Dehiscence (closure) and pain (mesentery, organs)

32
Q

What are some common surgical indications in food animals?

A

Vagal indigestion (bloat), abomasal displacement, cecal disorders, rectal prolapse

33
Q

What is type 1 vagal indigestion?

A

Failure of eructation (mechanical, physiologic)

34
Q

What is type 2 vagal indigestion?

A

Failure of omasal transport (mechanical, neurogenic);

[Failure of feed and ingesta to move thru the omasum]

35
Q

What is type 3 vagal indigestion?

A

Failure of abomasal outflow (mechanical, neurologic, neuromuscular)

36
Q

What type of bloat is shown here?

A

1

37
Q

What type of bloat is shown here?

A

2 and 3

38
Q

What are the 3 types of rumenostomy?

A

Emergency, therapeutic, permanent

39
Q

How do you prepare for a therapeutic rumenostomy?

A

Like a left PL fossa celiotomy

40
Q

What is the approach for a therapeutic rumenostomy?

A
  1. Dorsal half of fossa
  2. 6-8 cm diameter incision –> rumen
  3. Exteriorize rumen –> place stay sutures
41
Q

What suture material and pattern are used to close the serosa/fascial layers of a therapeutic rumenostomy?

A

Absorbable;

continuous, interrupted

42
Q

What suture material and pattern are used to close the mucosa/skin of a therapeutic rumenostomy?

A

Absorbable;

continuous, interrupted

43
Q

What are indications for a rumenotomy?

A

Exploration, foreign body, rumenal evacuation

44
Q

What is the approach for a rumenotomy?

A

Left PL fossa celiotomy

45
Q

What is the general procedure for a rumenotomy?

A
  1. Exteriorize rumen
  2. Seal rumen to skin
    1. Rumen board
    2. Suture - non-absorbable, continuous (2 lines)
  3. Incise rumen
46
Q

What suture pattern and material do you use to close the rumen?

A

Absorbable, continuous inverting

47
Q

What are the different abomasal displacement syndromes?

A

LDA, RDA, abomasal volvulus (RVA)

48
Q

What are advantages to a closed LDA surgery?

A

Short procedure, minimal invasion, less costly

49
Q

What are disadvantages to a closed LDA procedure?

A

Difficult to confirm correction, personnel required, high recurrence rate, peritonitis

50
Q

What are the approaches to an open LDA and how is it corrected?

A

Right PL fossa = Omentopexy, pyloropexy

Right paramedian = abomasopexy

Left PL fossa = abomasopexy

51
Q

What are advantages to an open LDA correction via right PL fossa?

A

Standing, minimal restraint, allows exploration

52
Q

What are disadvantages of an open LDA correction via right PL fossa?

A

Only distal pyloric region visualized, adhesions

53
Q

What are the advantages to an open LDA correction via right paramedian incision?

A

Best access to abomasum, concurrent adhesion

54
Q

What are the disadvantages to an open LDA correction via a right paramedian incision?

A

Dorsal recumbency, other structures

55
Q

What are the advantages to an open LDA correction via the left PL fossa?

A

Standing, minimal restraint, concurrent adhesions

56
Q

What are the disadvantages to an open LDA correction via the left PL fossa?

A

Pexy requires long reach, limited exploration

57
Q

What 2 things can be done laparscopically in an LDA surgery?

A

Abomasopexy, assisted toggle pin

58
Q

What are the advantages to using laparoscopy to correct an LDA?

A

Decreased complication rate, visual confirmation

59
Q

What are the disadvantages to using laparascopy to correct an LDA?

A

Specialty equipment, technically challenging

60
Q

What are the approaches for open RDA/RVA surgery and what is done in each?

A

Right PL fossa = omentopexy, pyloropexy

Right paramedian = abomasopexy

61
Q

What are surgical disroders of the cecum?

A
  1. Dilation - distension without twist
  2. Torsion - long axis
  3. Volvulus - retroflexion (dorsal, ventral)
62
Q

What is the approach for cecal surgery and what can be done?

A

Right PL fossa;

Typhlotomy, Typhlectomy

63
Q

What are predisposing factors for rectal prolapse?

A
  1. Increased abdominal pressure or fill
  2. Coughing
  3. Colitis
  4. Cystitis
  5. Diarrhea
  6. Tenesmus
64
Q

What are treatments for rectal prolapse?

A

Reduction, amputation (devitalized tissue)

Intro to Surgery (36 decks)

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