OVH Flashcards

1
Q

What is the attachment of the proper ligament?

A

Uterine horn to caudal pole of the ovary.

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2
Q

What is the attachment of the suspensory ligament?

A

cranial pole of the ovary and the body wall.

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3
Q

What three tissues make up the Broad Ligament?

A

Mesovarium + Mesometrium + Mesosalpinx

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4
Q

What are the components of the Broad Ligament?

A

Ovarian & Uterine vessels, +/- fat

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5
Q

What is the Round Ligament?

A

Remnant of the gubernaculum.

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6
Q

Where do right & left ovarian arteries branch from?

A

Aorta

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7
Q

Where do right & left ovarian veins drain?

A

Right Ovarian v.= vena cava

Left Ovarian v. = left renal v.

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8
Q

What instrument is used to clamp the proper ligament?

A

Mosquito forcep

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9
Q

T/F: The mosquito forcep clamped to the proper ligament should be used to manipulate the ovary during OVH.

A

False! Clamp the proper ligament, but hold the ovary or uterine horn for manipulation

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10
Q

Should the suspensory ligament be cut or digitally broken down?

A

Digitally broken down to exteriorize the ovary.

CAUTION: Complete breakdown of the suspensory ligament can tear into the pedicle causing hemorrhage

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11
Q

Which surgical technique is appropriate for most patients when ligating the ovarian pedicle?

A

Modified Triple Clamp Technique.

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12
Q

What ligatures are used in the Modified Triple Clamp technique?

A

1st Ligature: Circumferential Miller’s Knot in the proximal crush
2nd: Transfixation or surgeron’s knot; must flash clamp (why?)

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13
Q

What suture type & size are you going to use to ligate in most OVH procedures?

A

Absorbable, monofilament, 2-0

Note: Giant breeds you can use size 0

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14
Q

T/F: The uterine body is ligated and transected caudal to the cervix, thus requiring complete exteriorizing of the cervix.

A

False. The uterine body is ligated & transected CRANIAL to the cervix, thus you do NOT need to exteriorize the cervix.

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15
Q

All vessels of the uterine body are located in what part of the broad ligament?

A

Mesometrium.

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16
Q

The uterine artery arises from where?

A

Internal pudendal artery

17
Q

Breakdown of the broad ligament should be conducted in this fashion in an effort to reduce the risk to vessels & thus reduced risk of intra-op complications.

A

Begin caudally near the uterine body & work laterally.

18
Q

T/F: Uterine vessels should be ligated individually.

A

True.

19
Q

The left ovarian pedicle can be located using the ‘colonic maneuver,’ what is it?

A

Retracting the colon medially; the mesocolon will retract the jejunum, thus revealing the approximate location of where a dropped left pedicle may be.

20
Q

How would you locate a dropped right ovarian pedicle?

A

“Duodenal Maneuver”–retract the duodenum medially; mesoduodenum will retract the jejunum.

21
Q

What is the first step when uncontrolled hemorrhage is encountered during OVH?

A

Extend the incision.

22
Q

What is the holding layer during OVH closure?

A

External rectus sheath/fascia

23
Q

Why should suturing muscle be avoided?

A

It does not add strength to the closure and increases inflammation

24
Q

What two suture patterns can be used to close the holding layer?

A

Simple interrupted & simple continuous

Bonus Question: why is simple continuous the least preferred pattern?

25
Q

What is the ideal suture type for closing the external rectus fascia?
BONUS Question: why?

A

PDS, 2-0

Bonus Answer: because PDS takes ~60days to lose 50% of it’s tensile strength and the fascia takes ~6 weeks to heal.

26
Q

What is the most common immediate post-op complication of OVH?

A

Hemorrhage

27
Q

What are two other important immediate post-op complications assoc. w/ OVH besides hemorrhage?

A

Dehiscence of abdominal incision & ligation of a ureter.

28
Q

T/F: The uterus should not be clamped until after ligation when performing OVH in felines due to friable tissues.

A

True.

29
Q

What are some differences between OVH in canines vs. felines?

A

Incision: middle 1/3 of caudal abdomen
SQ tissues separate easily
Single ligatures usually sufficient (Miller’s Knot)
Ligate closer to the bifurcation