Surgery Rounds 1 Flashcards
A veterinarian meets the Professional Practice Standard: Informed Client Consent when:
- Obtains consent from a client who is over the age of 18
- Ensures the consent relates to the diagnostic procedure(s), intervention(s) or course of treatment
- Provides comprehensive information to the client including:
- Differential and/or definitive diagnosis
- Nature of the proposed diagnostic procedure(s), intervention(s)
or course of treatment
- The proposed benefits, common side effects and any serious risks
- Other reasonable alternative courses of action including the risks/benefits
of each
- The consequences if the proposed action is refused - Answers all questions and ensures that the client understands the information provided
- Discloses if auxiliaries or other veterinarians may provide some or all of the care of the animal(s)
- Provides an estimated cost of the intervention, using a range when appropriate
- Indicates in the medical record that consent was obtained and, for interventions or courses of treatment that are of higher risk, obtains consent in writing where feasible
- Understands that revealing information concerning a client, or animal, or any professional service performed for an animal to a person other than the client or another member treating the animal is not permitted without the client’s consent, except when doing so is required or authorized by law
gastric foreign body dog
- continuing to vomit despite anti-nasea drugs in hospital
- when do we take him to surgery?
- Now
how to prepare prepuce for male dog ex. lap?
- Clip and prepare prepuce
- Lateralize tip of the prepuce using towel clamps
- Drape over tip of prepuce
when is partial splenectomy appropriate?
- Preserves splenic function
- Reserved for cases with focal non-malignant, incidental non-ruptured splenic lesions:
- Abscess
- Splenic Trauma
- NOT FOR NEOPLASIA
what arteries go to the spleen?
which do we ligate for splenectomy?
- short gastric aa.
- splenic a.
- dorsal branch
- main splenic branch (x2)
- omental branch
<><>
-we must ligate:
> all 3 branches coming from gastric aa.
> dorsal, main (x2), and omental branch of splenic a.
liver biopsy protocol
- where do we put laparotomy sponge
- which lobe?
- what type of sample?
- Laparotomy sponge between liver and diaphragm / Assistant
- Most accessible lobe
- Representative sample of focal lesion
> Guillotine/loop biopsy
> Skin punch biopsy
how to take a guillotine biopsy of the liver?
- type of suture
- technique
- how much
- how many throws
- what if hemorrhage?
- 3-0 or 2-0 Biosyn or PDS
- Single throw better than surgeons throw
- ~1cm of tissue
- Crush all the way (through capsule and parenchyma)
- 4 throws
- Leave a small stump (ischemic)
- Gelfoam, Surgicel or suture if hemorrhage
when to take liver punch biopsy?
- how far to go
- how to control bleeding
- forceps?
- Focal mass lesions (diaphragmatic surface vs visceral surface)
- 4-6mm Keyes punch biopsy
- Invade less than 50% thickness
- Pressure to control bleeding
- Don’t grab with forceps!!!!
- +/- Gelfoam
gastrotomy
- how to isolate stomach
- how to keep in place
- where to cut
- how to get out material
- closure method and suture
- holding layer?
- Isolate the stomach with moistened laparotomy sponges
- Place stay sutures
- Stab incision between the lesser and greater curvature
- Assistant milks material out of your incision
- Two-layer closure
- Monofilament long acting absorbable suture
(ie. PDS) - Submucosa is holding layer
anderson technique for relieving plication related to linear foreign body
jejenum with string foregin body
1. soft rubber catheter tied to oral end of foreign body
2. small enterotomy to expose foreign body
3. rubber catheter inserted into intestine in aboral direction pulls f. body with it
4. rubber catheter completely fed into intestine, enterotomy closed
5. plication relieved
for ex. lap we cut from
xiphoid to pubis
why can’t we just ligate and cut the splenic artery when doing a splenectomy?
- because it provides a branch to the pancreas, and if we accidentally cut below this branch we will cut off that blood supply to the pancreas
if we have splenic torsion, should we untorse it before we take it out?
no, due to the many inflammatory mediators that would then be let inot the body > make the dog very sick
breeds for splenic torsion
GSD, great dane
