SL1 - Exploratory Celiotomy and Cystotomy

Question 1

celiotomy

Answer 1

any surgical incision into the abdominal cavity

Question 2

laparotomy

Answer 2

refers to a flank approach

Question 3

indications for emergency laparotomy

Answer 3

uncoltrollable hemorrhage

GDV

perforated GIT

bile peritonitis

Question 4

what is gossypiboma

Answer 4

retained foreign object during surgery

sponge and instrument counts, radiopaque sponges, unfold songes

Question 5

surgical approaches

Answer 5

ventral midline

paramedian

paracostal

flank

combined - ventral midline & paracostal, ventral midline & median sternotomy

males - midline/parapreputial

Question 6

ventral midline approach

Answer 6

aim is to incise through linea alba - visualized best at umbilicus

avoid rectus abdominis muscle

Question 7

approach for exploratory celiotomy

Answer 7

ventral midline approach

stab inscision - cranial if using scalpel, cauda is using scissors

from xyphoid to pubis for complete exploratory

Question 8

falciform ligament

Answer 8

move to side

my need to remove it if still getting in the way

Question 9

T/F with exploratory celiotomy biopsies are almost always indicated even if no gross lesions

Answer 9

True

Question 10

structures in cranial quadrant

Answer 10

diaphragm

stomach

liver and gal bladder

left limb of the pancreas

Question 11

structures in the right quadrant

Answer 11

duodenum and right limb of the pancreas

right kidney

uterus

adrenal gland

Question 12

structures in left quadrant

Answer 12

colon

uterus

left kidney and adrenal

spleen

Question 13

structures in central abdomen

Answer 13

ileocecal colic junction

illeum and jejunum

mesenteric L.N

transverse colon

bladder

Question 14

biopsy methods

Answer 14

needle core

incisional

Question 15

what should be done before closure

Answer 15

check for hemorrhage

sponge count

lavage abdomen - warm sterile saline, copious amounts

Question 16

what is the holding layer

Answer 16

external rectus fascia

Question 17

how many layers should be used to close

Answer 17

3

external rectus fascia is the holding layer!

Question 18

purpose of SQ tissue closure

Answer 18

relieve dead space

better skin apposition

Question 19

when should the knot be burried

Answer 19

SQ pattern

intradermal patterns

Question 20

suturing the bladder

Answer 20

watertight closure

1st layer - simple continuous

2nd layer - inverting pattern (cushing, lembert)