Rumen/Reticulum Surgery

Question 1

What are the indications for Rumen Surgery

Answer 1

• Frothy bloat
• Free gas bloat/Chronic re-occurring bloat
• Ruminal foreign bodies (Hardware disease, others)
• Vagal indigestion
• Grain overload
• Toxin ingestion
• Experimental/Research
• Making a rumen donor (insertion of a Rumen Canula)

Question 2

What is the ‘coffee cup’ method for measuring fibrinogen?

Answer 2

• Heat precipitate from plasma and measure difference of TP between samples. Normal should be less than 500 g
• 130F water for 3 minutes
  
  • difference between TP measurements is estimated fibrinogen

Question 3

What is a Rumenotomy?

Answer 3

• Part of the dorsal rumen sac is exteriorized through the laparotomy incision
• Starting at the dorsal aspect of the incision, the rumen is sutured to the skin in a Cushing-type pattern to form a seal between the rumen and skin
• Partial thickness bites should be taken through the rumen wall
• After the seal is created between rumen and skin, the rumen is incised leaving ~3cm at the dorsal and ventral part

Question 4

What anesthesia is provided during a Left Flank Laparotomy?

Answer 4

• Local or Regional
  
  • Proximal/Distal Paravertebral nerve block
  • Inverted L-block
  • Line block
• 2% Lidocaine HCl

Question 5

How is a Left Flank Laparotomy performed?

Answer 5

• Skin incision (~20cm dorsoventral) in left paralumbar fossa
  
  • 4 cm hand width caudal and parallel to last rib
  • 6-8 cm ventral to the transverse processes of the lumbar vertebrae

Question 6

What methods exist for Rumenotomy?

Answer 6

• Skin Fixation techniques*
• Rumen boards*
• Rumen Skin Clamp Fixation
• Stay Suture Rumenotomy
• Weingarth’s Ring Rumenotomy

Question 7

What are the goals of a Rumenotomy?

Answer 7

• Avoid peritoneal contamination
• Gain access to rumen

Question 8

What is Skin Suturing Fixation for a Rumenotomy?

Answer 8

• Dorsal sac of rumen is exteriorized through left flank incision
• Rumen was sutured to skin using #2 silk in a continuous Connell Pattern
• Suturing began midway down caudal part of incision and continued in a clockwise direction
• Suture pulled tight to invert skin edges under rumen for a good seal

Question 9

What is a Rumenotomy Board (Gabel Rumen Retractor), how is it used?

Answer 9

• metallic board with hole for surgery site and prongs for holding stay sutures
• Make incision in the foal of the rumen wall starting ventrally placing hooks as the incision is made

Question 10

What is a Rumen Skin Clamp Fixation

Answer 10

• Rumen is exteriorized through incision and firmly anchored to skin dorsally and ventrally by towel clamps
• Rumen is opened and towel clamps are placed cranially and caudally
• Additional clamps placed between these clamps
• Rumen edges are made to overlap the skin edges by 2-3cm