OHE Flashcards
What is the difference of an OHE and OVE?
OHE: sx removal of ovaries and uterus
OVE: removal of ovaries alone
T/F: OVE puts a patient at risk for future pyometra?
FALSE- no disadvantage, quicker procedure and removing source of progesterone
What are some indications of an OHE?
Elective sterilization Tx of ovarian neoplasia Tx or prevention of uterine dz Prevention/treatment of vaginal hyperplasia/prolapse Prevention of mammary neoplasia
What are some advantages of an OHE?
Prevention of mammary tumors Idiopathic epilepsy (estrogen related) Diabetes mellitus (progesterone blocks insulin)
What are four disadvantages of an OHE?
Obesity (decreased metabolic rate, increased appetite)
Orthopedic problems (Hip dysplasia, CCL rupture)
Urinary incontinence (20% spayed bitches-estrogen controls sphincter mechanism)
Neoplasia (HSA, Lymphoma)
What is the length off the midline for a OHE for draping?
2-3 cm off ventral midline
What are the landmarks for the quarter drapes and the final drape?
Quarter drape: xiphoid to pubis
Final drape: umbilicus to pubis
How far should the SubQ be dissected away from the fascia?
5 mm blunt dissection
What is a complication that can occur if too much dead space has been created?
Seroma
Where are the ovaries located?
Caudal pole of the kidney
Where does the uterine body lie?
Between bladder and colon adjacent to ureters
The uterine horns are positioned where?
dorsolateral abdomen
How do you retrieve the uterine horn with a spay hook?
Place in incision w/ hook facing abdominal wall
Reach dorsal gutter
Turn hook 180 degrees towards midline
Where is the proper ligament?
Between ovary and uterine horn
Where is the suspensory ligament?
cranial pole of ovary to body wall/last rib
Where do the ovarian arteries come from?
directly off the aorta
What do the right and left ovarian veins drain into?
Right: vena cava
Left: left renal vein
What are the two clamping methods used for OHE?
Modified 3 clamp technique
3 clamp technique
Where are the miller’s and transfixing ligature placed in relation to the clamps?
Millers knot placed in crush of most proximal clamp
Transfixing ligature proximal to middle clamp (flash!)
What are two monofilament absorbable suture that can be used?
Polydioxanone
Poligecaprone
What are two braided absorbable suture that can be used?
Polygactin 910 (vicryl) Polyglycolic acid
Why should non-absorbable suture be avoided?
Fistulous tracts
What are the suture sizes used?
2-0 for most
3-0 for toy breeds
0 for giant breeds
What are four things that you should always do in an OHE procedure?
Check ovarian bursa to ensure you have removed entire cavity
Remove ovaries/uterus from sx field
Remove blood from dorsal gutters
Look for hemorrhage
How should you check the ovarian pedicles?
Left pedicle
Mesocolon medially
Right pedicle
Mesoduodenum medially
What size suture should be used in subQ and what pattern?
3-0 and simple continuous pattern with a buried knot
What skin pattern should be used and what size suture?
Cruciate pattern with a 3-0 non-absorbable monofilament suture
What is the most common cause of death in a OHE procedure?
Hemorrhage
What are three common causes of hemorrhage?
Tearing of pedicle while strumming
Incomplete ligation
Loose ligatures
What size dogs have an increased risk of hemorrhage?
> 25 kg. patients
What can be a result of inappropriate aseptic technique or increased anesthesia time?
Infection
What can be a complicaiton of inappropriate sx technique or inappropriate aftercare?
Dehiscence
T/F: Males may still try and mate with a dog in estrus early post-op
TRUE
What complicaiton leads to uroabdomen or hydronephrosis?
Ligation/clamping injury of ureter (may require ureteronephrectomy)
What is the approach for a feline OHE?
middle 1/3 of caudal abdomen
Shorter incision
T/F: In cats the SubQ typically not closed
TRUE- not much available to close
