Ovariohysterectomy Theory Flashcards

1
Q

What is the most common surgical procedure?

A

Ovariohysterectomy

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2
Q

What is the purpose of an ovariohysterectomy?

A
  • Surgical removal of the ovaries and uterus for the purpose of sterilisation
  • Treatment of reproductive tract disease
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3
Q

Difference between
- ovariohysterectomy
- ovariectomy

A

Ovariohysterectomy: surgical removal of the uterus and ovaries

Ovariectomy: only the ovaries are removed. Skin and fascia incisions are considerably smaller and located more cranially with ovariectomy

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4
Q

Advantages of Laparoscopic procedures

A

Minimally invasive veterinary surgery maximising post operative patient comfort
- superior visualization
- use of vessel-sealing technology
- smaller incisions

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5
Q

Ovariohysterectomy Indications (elective)

A

Desexing
Reduction of mammary neoplasia risk
Treatment of behavioural conditions
Treatment of medical conditions
Council registration (cheaper)

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6
Q

Ovariohysterectomy Indications (disease)

A

Pyometra
Metritis, subinvolution of placental sites
Uterine torsion
Uterine prolapse
Uterine rupture
Uterine neoplasia
Persistent pseudopregnancy

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7
Q

Standard age to desex females

A

About 6 months
- preferably before the first or second oestrus

(but for many years welfare organisations were desexing between 8-12 weeks of age)

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8
Q

Considerations when desexing young (8-12 weeks) - positive

A

Claimed decreased stress and operative time
Assurance animal is desexed when rehomed
Decreased maturation of external genitalia

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9
Q

Considerations when desexing young (8-12 weeks)- negative

A

Increased incidence of oestrogen responsive urinary incontinence
Anaesthetic risk
Increased risk of bony neoplasia in giant breeds

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10
Q

Why is it more risky to complete an ovariohysterectomy when in season?

A

Uterus is more friable (easily crumbled)
Increased blood supply
Oestrogen (which is surging at the time) can have a detrimental effect on haemostatic mechanisms

Can be a difficult procedure - need to warn owner of increased risk

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11
Q

How long do you delay an ovariohysterectomy?

A

Delay for 4 weeks after the onset of pro-oestrus

After a litter, wait 3 weeks after weaning (to allow mammary tissue to involute/ return to normal size)

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12
Q

Is it easier to spay an early pregnant bitch or a bitch in season?

A

Early pregnant bitch

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13
Q

Risk of mammary neoplasia

A

0.5% if spayed before 1st oestrous
8% if spayed after the first oestrous
26% if spayed after the second oestrous

NO DECREASE if spayed after 4 oestrus cycles

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14
Q

Incidence of mammary tumours in entire cats

A

7 X the incidence

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15
Q

What suspends the uterus and ovary in the abdominal cavity?

A

Paired double folds of peritoneum
- the BROAD Ligaments

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16
Q

What are the 3 broad ligaments?

A

Mesovarium
Mesosalpinx
Mesometrium

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17
Q

What is the suspensory ligament?

A

The cranial continuation of the broad ligament from the ovary
- coalesces (comes together) into a distinct band

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18
Q

Where does the suspensory ligament insert?

A

On the middle and ventral thirds of the last 2 ribs

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19
Q

What does the proper ligament do?

A

Attaches the ovary to the uterine body

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20
Q

What attaches the ovary to the uterine body?

A

The proper ligament

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21
Q

What does the proper ligament become ?

A

Continues caudally as the round ligament

22
Q

Where does the round ligament go?

A

Caudal continuation of the proper ligament

Courses within the broad ligament , passing through the inguinal canal and terminating subcutaneously near the vulva

23
Q

What ligament courses through the broad ligament?

A

The round ligament (caudal continuation of the proper ligament)

24
Q

What ligament terminates subcutaneously near the vulva

A

The round ligament (caudal continuation of the proper ligament)

25
Q

What is the name of the ovarian blood supply?

A

Ovarian arteriovenous complex

26
Q

Where does the ovarian arteriovenous lie?

A

Medial to the broad ligament
Caudal to the suspensory ligament

27
Q

Shape of the ovarian arteriovenous

A

Convoluted especially closer to the ovary

28
Q

What is the ovarian artery?

A

A direct branch off the aorta

29
Q

Where does the right ovarian vein drain?

A

Into the caudal vena cava

30
Q

What drains into the caudal vena cava ?

A

The right ovarian vein

31
Q

Where does the left ovarian vein drain?

A

Into the left renal vein

32
Q

What drains into the left renal vein?

A

The left ovarian vein

33
Q

What supplies the ovary and cranial aspect of the uterus?

A

The ovarian artery

34
Q

What does the ovarian artery do?

A

Supplies the ovary and cranial aspect of the uterus

35
Q

What is the uterine artery ?

A

A branch of the internal pudendal artery

36
Q

Where is the uterine artery positioned?

A

On the lateral aspect of the uterine bodies bilaterally

37
Q

Where are anastomoses believed to exist?

A

Between ovarian and uterine arteries

38
Q

Where does the uterine artery enter the mesometrium?

A

At the level of the cervix

39
Q

Where do the lymphatics drain?

A

Drain to the hypogastric and lumbar lymph nodes

40
Q

Innervation (sympathetic + visceral)

A

Hypogastric plexus

41
Q

Innervation (parasympathetic + visceral)

A

Pelvic nerves

42
Q

Is ventral midline or flank preferred?

A

Ventral midline

43
Q

Advantages of ventral midline over flank (4)

A

Better access to peritoneal cavity if problems

Can check haemostasis

Access to right ovary can be difficult through flank approach

Anecdotally increased incidence of seroma (fluid build up) in flank approach due to 3 x muscle layers

44
Q

Which approach is commonly performed in UK?

A

Flank
+ at some welfare centres and private practices

45
Q

Which species has the more mobile cervix?

A

Canine

46
Q

Which species ovaries are easier to expose

A

Feline

47
Q

Location and size of canine incision

A

1-2cm caudal to umbilicus
extending 5cms

48
Q

Location and size of feline incision

A

3-4 cm incision
centred over the midpoint between the cranial rim of the pelvis and umbilicus

49
Q

Where are the uterine horns located?

A

Dorsolateral gutter of the abdomen

50
Q

Where is the uterine body located?

A

Ventral to the rectum
Dorsal to the bladder