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Reproduction > Repro Surgical Procedures SA > Flashcards

Repro Surgical Procedures SA Flashcards

1
Q

How is OVH usually performed (incision)?

A
  • ventral midline

- flank in cats

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2
Q

What is the NRCW classification of OVH?

A
  • clean contaminated as entering a viscus
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3
Q

How can the uterus and ovaries be located following vetnral midline incision?

A
  • push intestines cranially and bladder caudally (uterus)

- follow uterine horns to ovaries

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4
Q

How are the ovaries released?

A
  • Break the suspensory ligament - cutting more controlled than tearing, incise near kidney
  • Create a window in the mesovarium AWAY from the overian a. and v. (ovarian a. arises from aorta)
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5
Q

How should the pedicle be clamped once the suspensory ligament has been transected?

A
  • 3 forcep technique

- remove forcep most proximal to stump and tie a ligature here, then incise between remaining forceps

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6
Q

Which suture matierla should be used for the ovarian ligature? Knot?

A
  • Vicryl (Polygalactin 910)

- Encircling ligature/figure of 8

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7
Q

How can risk of slippage of ovarian ligature be reduced?

A

Leave 0.5cm gap between cut edge

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8
Q

What is the 2nd ligament that must be ligated after transecting between the two clamps? Why is this ligated not transected? What suture material should be used?

A

Broad ligament

  • contains small vessels
  • synthetic absorbable suture
  • Vicryl (Polyglactin 910)
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9
Q

What must be ligated following incision of the broad ligament? Suture material? Method? Ligature?

A
  • cervix
  • Vicryl (Polyglactin 910)
  • 3 forcep technique
  • encircling, transfixing or stick ties may be used
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10
Q

What should be checked for before clamping the cervix?

A

Cat is not in season - uterus becomes v. friable and will not be suturable! Will break down.

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11
Q

Which flank is entered for a cat spay?

A

Left

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12
Q

Which cats should not be spayed via the flank?

A

Oriental - hair will grow back dark and owner will not be happy

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13
Q

How can the ovarian pedicles be loacted once the OVH is compelte?

A
  • right ovarian: elevate descending duodenum
  • right broad: elevate desceding duodenum and move SI to the left [more difficult to find]
  • left ovarian: elevate descending colon
  • left broad: elevate descending colon
  • cervical pedicle: elevate bladder and reflect caudally
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14
Q

Outline potential complications of OVH

A 
>general surgical complications 
- wound dehiscence
- infection
- haemorrhage
- retained swab 
- anaesthesia risks 
>specific
- urethral injury (eg. urethra included in cervical ligature)
- retained ovarian remnant
> other sequalea
- SMI incontinence
- weight gain
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15
Q

When may OHE be indicated?

A
  • more logical for steralisation alone

- not appropriate for management of uterine disease

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16
Q

Indications for C section

A 
> fetal distress [more humans]
> dystocia due to 
- 1* uterine inertia (gestation >70d) 
- Incomplete 1* uterine inertia refractory to medical managmeent 
- 2* uterine inertia (exhaustion) 
- fetal oversize
- anatomical abnormality of maternal pelvic canal 
- malpresentation
- foetal death 
-previous C sec
17
Q

Pre-op considerations before C sec?

A
  • electrolyte and other metabolic abnormlaities eg. hypoglycamia
  • foetal death ^ significantly after 5 hours since onset of 2nd stage labour
  • advise owners of risks of Sx
18
Q

What is a C sec classified as according to NRCW?

A
  • clean/contaminated

- dirty

19
Q

C sec specific anaesthetic considerations?

A
  • depression of neonates
  • local block and epidrual for dam
  • AVOID a2-ags, ketamine and thiobarbiturates
  • minimise time taken to remove foetuses
20
Q

Outline C- sec sx

A
  • midline incision (careful of foetuses!!)
  • exteriorise uterus
  • milk babies out (dont force)
  • clamp umbilical cord
  • repair uterus with monocryl (poliglecaprone 25)
  • simple apositional/inverting pattern, single or double layer
21
Q

Main aspects of neonate care?

A
  • dry and warm
  • clear airways (suction)
  • check congential abnormalties
  • make sure dam ok and looking after young
22
Q

Potential complications of c-sec?

A
  • general Sx
  • make sure ALL FOETUSES removed - check pelvic canal vaginal exam
  • post-parturient probs (uterine haemorrhage, retained placenta/foetuses, acute metritis, subinvolution of placental sites, uterine rupture or prolapse, toxic milk syndrome, agalactia, galactostasis, acute mastitis, puerperal tetany, disturbed maternal behaviour)
23
Q

What is an alternative method to c-sec?

A

> En Bloc

  • OVH then remove neonates all at once
  • survival comparable to normal
  • disadvantage all neonates need rescuss at once
  • minimises anaesthesia time and peritoneal contamination, no need for 2* Sx for population control
24
Q

How is castration performed in the dog and cat?

A
  • single pre-scrotal incision in the dog

- paired scrotal incisions in the cat

25
Q

What is the NRCW classification of castration?

A

clean

26
Q

Outline the open castration technique

A
  • push testcle cranially and make incision in vaginal tubic over this to protect penis
  • remove testicle
  • ligate artery and spermatic cord using 3 forcep technique and Vicryl (ployglactin 910)
  • encircling or transfixing ligature
27
Q

What are the advantages of open castration

A
  • clear view of spermatic cord

- decreased post op swelling and risk of ligature slippage

28
Q

What are the advantages of closed castration?

A

v risk intestinal herniation

29
Q

How does cat castration differ from dog?

A
  • Performed as clean not aseptic procedure
  • ligatures rrely used
  • vas deferens and spermatic vessels knotted together
  • or overhand knot in spermatic cord
30
Q

What is scrotal ablation? When is it indicated?

A
  • removal of scrotum as well as testes
  • scrotal disease eg. MCT or trauma
  • improved cosmesis, v complications in mature dogs
  • part of scrotal/perineal urethrostomy
  • scrotal skin donor
31
Q

How may lost cryptorchid testicles be located?

A

ultrasound (often hidden my inguinal fat pads and hypoplasia)

32
Q

What surgical approaches may be used to remove cryptorchid testicles?

A
  • inguinal
  • caudal midline laparotomy
    > trace gutter from caudal kidney pole to inguinal ring
33
Q

What shuold be considered after removing a cryptorchid testicle?

A

submitting for pathology

removing scrotal testicle (standard procedure but make sure you have owner consent!!)

34
Q

Potential complications of castration

A
  • general Sx
  • scrotal swelling
  • urethral injury
  • failure to locatte retained testicle
  • weight gain
  • SMI
  • anaesthesia complications
35
Q

Are vet nurses allowed to perform castration?

A

no

36
Q

Is use of prosthetic testicles ethical?

A

no according to RCVS

Reproduction (30 decks)

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