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
