Neutering Flashcards
What Pre-op considerations for OVH ?
- Wide clip
- Express bladder
- Wide drape
- Suture materials
- ABs not needed if elective
Describe first incision in OVH
- Ventral midline incision -> sharp slide cut one long smooth incision; fingertip grip
Step one after incision is made?
Find the linea alba -> tent and stab (check for adhesions) avoid rectus muscle
Step 2 OVH?
- Incise from umbilicus caudally
- Locate ovary
- Break suspensory lig
STEP 3?
Create a window with the broad ligament (caudal to vessels of pedicle and dorsal ovarian & uterine vessels)
Describe the three clamp technique
PlAce 2 or 3 clamps across pedcle as far below ovary as poss
PLACING 2 LIGATURES
- Encircling ligature in crush of most dorsal clamp
- 2nd encircling or transfixing b/w 1st and pair of clamps
Step 4?
Transect the pedicle between the two clamps
What to do after cutting pedicle?
- Release clamp, check stump for bleeding, slowly release into abdomen
- Follow uterine horn to the contralateral horn adn ovary
- Traction cranially and ventrally, extend incision if needed
- Duodenal manoeuvre
- Repeat on second ovary
What to consider when breaking down the broad ligament?
- Locate the utetine vessels
- Tear, cut & clamp, encircling ligature +/- clamp
removing the uterine body - how?
- 2 or 3 clamps to uterine body cranial to cervix
- Transfix and ligate int he crush of the distal clamp
- Transect between two remaining clamps
What to do before cloing abdomen?
- Check all stumps
- COUNT swabs
What 3 layers in closure?
- Linea alba
Subscut layer Skin closure
Describe linea alba closure
INCORPORTAE RECTUS ABDOMINIS M sheath -> wide bites, avoid fat/subcut tissues
=> Simple continuous or interrupted
What pattern for subcut?
Simple continuous
OVH in CAT
FLANK approach - 2cm below wing of illium - triangle (femur illum equilateral point)
OVH in CAT pt 2
- Remove small amount of fat bluntly
Make small incision in external, internal, oblique, rectus abdominis
How to locate uterine horn (cat)
- sublumbar fat (yellow) lifted dorsally then gentle tractionto exteriorise left ovary (fenestrate broad lig)
Clamps & ligation - Cat OVH
Clamp ( if poss) then double ligate and incise body - be CAREful with clamping body as friable
Surgical complications of OVH ?
- HAemorrhage (usually ovarian pedicles)
- Urinary tract injuries
- Ovarian remnent syndrome
- Stump granuloma (catgut)
- Iatrogenic pseudopreganncy
- infection & dehisence
What should you do for older fatty, pregnant or pyo animals?
Ligate the broad ligament
Are ABs indicated for routine OVH?
NO
What approach for pregnant or in-season cats?
Midline
What is the most common cause of post op haemorrhage in OVH?
Slipped ligatures -> so leave enough tissue above the ligature
Describre an open orchiectomy ?
- liogations are direct, more secure
- may be prefferabel in large dogs
- opening of an extension of the peritoneal cavoty, risk of intestinal herniation
- inc surgical time
Describe Closed Orchiectomy
- reduces operative time
- inc chance of ligature slippage
When should you do closed castrations?
- Always with testicular neoplasia
- Consider in dogs with pendulous scrotum
When should you consider scrotal ablation?
in dogs with pendulous scrotum, large dogs, or with trauma
Describe pre scrotal incisions
Quicker but inc haematoma and seroma formation
What complications can occur with ohiectomy?
- Scrotal bruising & swellin
- Haemorrhage
- Scotal haematoma
- Infection
- Self trauma
T/F - for close castration you should stip away fat/ tissue prior to ligating cord
True
