Ovariohysterectomy Procedure Flashcards
What do you use a spay hook for?
Introduced into the abdomen with the hook parallel to the body wall
It is then rotated 90 degrees and moved towards the midline
Disadvantages of spay hook?
Sometimes GIT structures are hooked and it may be necessary to palpate with a finger
Which ovary is more difficult to exteriorise?
The right ovary
Which ligament do you break/ stretch first?
The suspensory ligament
What do you create a window in in order to be able to ligate the ovarian pedicle?
Window in the mesovarium
Caudal to the ovarian vessels
How do you clamp the ovarian pedicle?
Triple clamp with carmalt-rochester forceps
Where do you clamp the ovarian pedicle?
Proximal to the ovary (if possible)
otherwise, one clamp between ovary and uterus
What does the selection of suture size depend on?
The amount of fat in the pedicle
Your confidence in your ligature
2 types of suture material for ovarian pedicles
BOTH ABSORBABLE MONOFILAMENT
PDS (polydioxanone suture)
Polyglyconate
Suture size for ovarian pedicles
Dogs 0 - 2/0 - 3/0
Cat 3/0
What to do after you transect the pedicle
Hold the pedicle in forceps without tension before releasing into the peritoneal cavity
How to transect the broad ligament (2nd)
cut or break with fingers
What do you need to avoid when breaking the broad ligament?
The uterine vessels
Extra step in multiparous, pregnant or mature dogs?
There may be large branching vessels that require ligation
Uterine body clamps
1-2 clamps just cranial to the cervix
What is the role of the cervix?
Natural barrier to the exterior
How much uterine body tissue should be removed?
As much uterine tissue as possible to prevent complications such as stump pyometra
Type of ligature for uterine body
Single, encircling ligature
When to use a transfixing ligature for uterine body?
If uterus is enlarged
i.e. pregnant or in season
How to ligate the uterine vessels?
Independent to the uterus
What do you need to check the abdominal cavity for?
Haemorrhage
Linea alba closure material
Monofilament, absorbable
PDS (polydioxanone suture)
Polyglyconate
1 - 3/0
Skin suture material
Non-absorbable
Polypropylene or Nylon or Polyamide
Intradermal suture material
Absorbabke
PDS or polyglyconate
What is the most common ovariohysterectomy complication?
Haemorrhage - 76%
3 types of wound healing complications
Suture reaction (most common in cats)
Seroma (fluid accumulation)
Fistulous tracts (abnormal passage)
4 causes of stump pyometra
Progesterone produced by remnants of ovarian tissue (or exogenous)
Stump inflammation or granuloma from non-absorbable material
Poor aseptic technique
Excessive residual devitalised uterine body
Urogenital complications (2)
- Accidental ureteral ligation
- Urinary incontinence (11-20% of desexed females)
How to treat post spay urinary incontinence
Stilboestrol or alpha agonists - to increase responsiveness of the smooth muscle of the bladder neck to nerve activity, tightening the muscle and preventing leakage of urine
Colposuspension - when drugs fail - improves pelvic floor and corrects position of the bladder neck to an intra-abdominal position (by cranially stretching the vagina and suturing it to the prepubic tendon on each side of the urethra)
In what percentage of patients is weight gain reported ?
26 - 38%
Where do you tie into?
The crush
