THIRD LABORATORY PRACTICAL LESSON PREPARING HANDS FOR OPERATION AND OPERATING FIELD
Exercise. Master the technique of preparing hands for surgery according to the method of Spasokukotsky Kochergin, Alfeld and Olivekov; learn to put on gloves and sterilize them; using experimental animals to learn how to shave the surgical field and process it according to the method of Filonchikov, Borchers and Mouse; acquire skills in processing mucous membranes.
Experimental animals. Large cattle or horses.
Preparing hands for surgery. Proper preparation hands for surgery is one of the most important measures to ensure aseptic surgery. It is known that the skin of the hands constantly contains a variety of microbes. They are located in the excretory ducts of the sebaceous and sweat glands, in numerous grooves and folds of the skin and in the subungual spaces. However, if the skin is elastic, without cracks and hangnails, then treating the hands using one of the methods accepted in surgery ensures their reliable sterility. If there are hangnails, ulcerations, cracks, or pustules on the skin of the hands, the number of bacteria increases noticeably, which makes it difficult to disinfect hands; they can become a source of infection surgical wounds. Therefore, the skin of your hands requires constant and attentive care.
Hand skin care. To maintain softness and elasticity of the skin, hands should be lubricated at night with Vaseline, lanolin, Tushnov liquid ( Castor oil- 5 g, glycerin - 20, wine alcohol 96° - 75 g) or Girgolava (glycerin, wine alcohol, ammonia and distilled water - 25 g each).
Methods for preparing hands. Preparing hands for surgery includes mechanical cleaning of hands and treating them with solutions.
10-20 minutes before surgery, hands are cleaned mechanically: nails are cut short, hangnails are removed, subungual spaces are cleaned and hands are thoroughly washed with soap and brushes.
Before use, brushes (hair and herbal) are boiled for 20-30 minutes in enamel pans and stored in glass jars in a 3% solution of carbolic acid or 0.1% solution of sublimate.
Pedal washbasins and a Vinogradov veterinary aseptic dispenser are convenient for hand washing.
The most common methods of hand treatment are the following.
The Spasokukotsky-Kochergin method. This method is based on the property of the solution ammonia(like alkalis) dissolve fats on the surface and in the pores of the skin and wash away bacteria along with them. Pre-washing your hands with soap and water and a brush is not necessary; It is resorted to in some cases in case of household contamination of hands.
The hand treatment technique is as follows. A freshly prepared warm 0.5% solution of ammonia is poured into two enamel basins. Use a sterile napkin to wash (wipe) your hands for 3 minutes, first in one basin, and then for 3 minutes in the other. When washing your hands, follow the following sequence: first, wash the ends of the fingers and nail beds, then the palmar and back surfaces of the hand, and finally the forearms. After this, the hands are thoroughly dried with a sterile towel and treated with 70-96" alcohol for 3-5 minutes. Finally, the nail beds are lubricated with GL.-vdm alcohol solution Yoda.
This method has been clinically tested on several million operations and is deservedly considered the best currently available. Its advantages are reliability, simplicity and harmlessness to the skin of the hands.
Alfeld's method. Hands are washed for 10 minutes hot water with soap and a brush, then wipe with a sterile towel, treat with 96° alcohol for 5 minutes and lubricate the nail beds with a 5% alcohol solution of iodine. With this method, reliable sterility of the hands is maintained for a short time (about 30 minutes).
Olivekov's method. Hands are washed for 5 minutes with hot water (40-50° C) with soap and a brush, wiped dry with a rough sterile towel and thoroughly wiped for 3 minutes with gauze balls or cotton wool soaked in an alcohol solution of iodine (1: 3000). At the end of the treatment, the subungual spaces are lubricated with a 5% alcohol solution of iodine.
Kiyashov's method. Hands are washed with a 0.5% solution of ammonia for 5 minutes, then treated for 3 minutes under running water with a 3% solution of zinc sulfate. The fingertips are lubricated with a 5% alcohol solution of iodine. This method is very effective (zinc sulfate solution has a tanning and bactericidal effect) and is always acceptable in veterinary practice.
Working with gloves and sterilizing them. All existing methods hand treatments do not ensure their absolute sterility; this can be achieved by using sterile rubber surgical gloves. The disadvantage of gloves is their low strength. In addition, gloves make the surgeon’s hands sweat a lot, resulting in the formation of “glove juice.” The latter contains microbes and if the glove is accidentally punctured with a needle, scalpel or other instrument, it can infect the wound. Therefore, before putting on gloves, hands must be treated using one of the methods discussed above.
Gloves are sterilized in several ways. Before sterilization, their integrity is checked. To do this, the gloves are inflated and immersed in a vessel with water. At the slightest damage, air will escape from the glove, which is easy to recognize by the appearance of bubbles.
Most convenient ways sterilization of gloves are as follows.
Sterilization in an autoclave. Each glove individually is carefully sprinkled with talcum powder inside and out, wrapped in gauze and sterilized in an autoclave along with the dressing material.
Sterilization by boiling. Each glove is wrapped in gauze and tied with threads to the sterilizer mesh so that they do not float up. Boil in water, without adding soda,
within 15 min.
Chemical sterilization. Gloves are immersed in a solution of sublimate (1: 1000) for at least an hour or in 2% chloramine for 15-20 minutes.
Gloves are put on wet hands and after putting them on, regardless of the sterilization method, they are wiped with alcohol.
Preparation of the surgical field. Preparation of the surgical field should be preceded by mechanical cleaning skin. The latter has an important preventive value, since it removes hair and dirt. a large number of microbes
Mechanical cleaning is carried out as follows. On the eve of the operation, the animal is thoroughly cleaned and, if possible, washed. warm water with soap. The operated area is trimmed with a clipper or Cooper scissors or, using water and soap, shaved (with straight or safety razors), washed thoroughly and dried with a towel. _
In case of emergency surgery hairline shaved dry, i.e. without water and soap, or with a 0.5-1/v solution of ammonia, or with a mixture of alcohol and ether. After mechanical cleaning of the skin, the surgical field is treated with solutions, and before the operation itself, it is isolated from surrounding areas of the body.
Methods for processing the surgical field. Treatment of the surgical field is carried out according to Filonchikov or Treatment of the surgical field according to Filonchikov. The surgical field is degreased with alcohol, ether or chemically pure gasoline, and then lubricated twice with a 5% or 10% alcohol solution of iodine. The first time is lubricated after fixing the animal, before the start of anesthesia, and the second time before making a skin incision. The interval between the first and second lubrication must be at least 5 minutes.
Treatment of the surgical field according to Mysh. The surgical field is lubricated with 5% lubricant three times aqueous solution potassium permanganate. The operation begins as soon as the skin dries. This method is recommended in the presence of dermatitis or paratraumatic eczema in the operated area.
Isolation of the surgical field. To prevent hair, dander, dust, etc. from getting into the wound from remote areas of the animal’s skin, the surgical field during surgery is isolated with sterile sheets or napkins with a slit in the center. When applying a sheet, the slot in it is placed above the surgical field and fixed to the skin1 with special clips (clips) or sutures.
Treatment with lysis of the shells. The mucous membrane of the nasal cavity is generously irrigated with a warm solution of rivanol (1: 1000), the skin at the entrance to nasal cavity lubricate with a 2-3% alcohol solution of iodine. The oral cavity is washed with a 0.1-0.2% solution of potassium permanganate, and the mucous membrane in the operation area is lubricated with a 3-5% alcohol solution of iodine. The conjunctiva is disinfected with a 0.5-1% solution of rivanol, a 3-4% solution boric acid or 2% solution of protargol.
IN last years For the treatment of mucous membranes, a solution of furatsilin (1: 5000 and 1: 10,000), solutions of biomycin, terramycin and mycerin are also used.
Control questions
1. What are asepsis and antiseptics?
2. What types of antiseptics are used in veterinary practice?
3. What needs to be done when preparing an animal for surgery?
4. What is the importance of postoperative keeping of an animal and what does it consist of?
5. What methods exist for sterilizing dressings, instruments and suture materials?
6. What methods are used to prepare the surgeon’s hands and operating room for surgery?
An operation or any procedure (manipulation) performed under anesthesia consists of several important stages:
- Preoperative period (pre-manipulation) - preparation of the animal.
- Operating period(the manipulation itself, requiring anesthesia) - performing a surgical intervention or procedure under sedation.
- Postoperative period - recovery and care of the animal after surgery or any procedure requiring anesthesia.
Preoperative period
He should never be underestimated. Any surgical intervention, whether elective or emergency surgery(procedure) carries certain risks to the life and health of the animal. This is due to the fact that operations and some procedures (manipulations) are carried out under general anesthesia(under anesthesia). The success of surgery and subsequent recovery directly depends on the preoperative preparation of the pet. During this period, the doctor draws up a general picture of the animal’s condition, finds out the severity of the underlying disease and the presence of associated violations(for example, cardiological). To minimize risks, carry out necessary examinations, sometimes additional therapy is prescribed.
For healthy animals up to 7 years old
Elective surgeries (for example) or procedures under anesthesia ( ultrasonic cleaning teeth, radiography under sedation) are most often carried out without additional examinations of pets. But only if they are under seven years of age and do not have a breed predisposition to heart disease. Such operations are prescribed without first seeing a therapist, and you can sign up for them simply by calling.
For animals over 7 years old or with a history of diseases
Pets of this age category A preliminary appointment with a therapist is required. This also applies to animals with any diseases (for example, chronic disease kidney or acute liver failure). And in case tumor processes You should make an appointment with an oncologist and surgeon in advance. For such animals, the day of surgery is assigned only after all the necessary examinations.
They must:
- General and biochemical blood test. shows the level of leukocytes, red blood (to exclude anemia), platelet count.
- Biochemistry. It is necessary to assess the functionality of the kidneys and liver in older animals (over 7 years), since many diseases of the liver, kidneys and heart can occur chronically, without clinical signs and symptoms, and during surgery they can lead to complications and even death of the animal.
Additional tests ordered for some animals
Radiography
It is necessarily carried out to exclude lung pathology, if tumor metastasis is suspected, etc.
Ultrasound
The study is carried out for visual assessment of organs abdominal cavity. It is prescribed for suspected free liquid in the chest or abdominal cavity, before cesarean section (including calculating the fetal heart rate), suspected tumor metastases or ruptures of abdominal organs, etc.
Electrocardiogram(ECG) should be performed on older animals with a history of loss of consciousness, chronic cough, and periodically blue mucous membranes and tongue. It will help identify cardiac rhythm and conduction disturbances, as well as mass indirect signs disturbances in the functioning of the heart and its structure.
ECHO of the heart used to determine the size of the chambers and muscles of the heart, to assess the function and structure of the valves, to identify regurgitation (reverse reflux of blood), etc. It must be carried out in purebred cats to exclude hereditary pathology - hypertrophic cardiomyopathy(HCM). Surrender of all necessary tests can be done in one or several days.
After examination and research, you can:
- draw conclusions about the need for surgical intervention (or performing one or another manipulation under anesthesia);
- set the time and date of the operation;
- carry out preoperative therapy in cases of abnormal test results.
It is very important that the animal is as stable as possible before anesthesia.
At good analyzes, surgery is scheduled for the near future.
If the operation is emergency, tests are prescribed individually in each case, taking into account the condition of the animal.
At home the day before surgery
A fasting diet is required 10-12 hours before the announced time of surgery. Absolutely any food should be excluded, and water should not be given 3 hours before surgery. This is due to the fact that while feeding the animal, vomiting of feed may occur. If this happens, there is a risk of development aspiration pneumonia. Therefore, a fasting diet is extremely important.
In the clinic on the day of surgery
On the appointed day, immediately before the operation, the necessary information is collected and the animal is thoroughly examined by an anesthesiologist. Next, the patient is taken to the hospital for the necessary surgical intervention. Purebred cats on the same day (or in advance) a cardiac ECHO is performed. After consultations with the anesthesiologist, the pet's owners sign a written consent to give the animal anesthesia and deposit the necessary funds into the balance. The owners' participation is no longer required at this stage; they can leave the clinic.
Surgery
Introductory anesthesia
Just before the start of the operation, premedication is carried out - the installation of intravenous catheters and the administration of an antibiotic. Next, the surgical field is prepared: a sufficient amount of hair is shaved to avoid it getting into the surgical incision and to ensure sterility.
Deep anesthesia
The animal is admitted to the operating room, where it is given deeper anesthesia, if necessary, the trachea is intubated and connected to gas anesthesia. At this time, the surgeon completes the preparation of the surgical field. Once the anesthesiologist is completely sure that the animal is sufficiently anesthetized and is in the required stage of sleep, he gives the command to the surgeon to begin the operation.
Operation
This is the period during which the necessary surgery (or procedure under sedation) is performed. The doctors work harmoniously: the surgeon and his assistant carry out the necessary surgical procedures, and the anesthesiologist monitors the animal’s vital signs. Heart rate is monitored, blood pressure(tonometry), frequencies breathing movements(it is possible to connect a ventilator), oxygen saturation of the body, and in some cases, ECG monitoring is performed.
Postoperative period
After the operation is completed, the animal is placed in a hospital. He is monitored until he fully awakens, and postoperative pain relief is provided. Most often, during anesthesia, a decrease in body temperature occurs; in this case, the animal is placed on a heating pad. As soon as the patient is admitted to the hospital, we call the owners and inform them that the operation is completed and how everything went. The next call to the owners is usually made 2-3 hours later, when the animal has woken up and can already be taken home. In some cases (during operations on the spinal cord, brain, unstable condition of the patient, etc.) it may be necessary to leave the animal in the clinic for a night or more to monitor the condition. We definitely warn the owner about this.
- necessary manipulations (treatment of sutures, external fixation devices, etc.);
- post-operative care(antibiotic therapy, massages, exercises, wearing a protective collar and/or blanket, etc.);
- timing of your next doctor's appointment.
Protective collar and blanket
Wearing protective blanket always necessary after abdominal operations: ovariohysterectomy (sterilization), caesarean section, pyometra, diagnostic laparotomy, foreign body removal, suturing umbilical hernia, gastric volvulus, mastectomy (removal of mammary tumors), removal of any formations from the skin in the chest, abdomen and groin area.
Protective collar necessary after castration (if the animal shows a strong interest in the operated area), osteosynthesis, installation of drains, removal eyeballs, excision of tumors from the skin or after suturing wounds where the defect cannot be hidden with a protective blanket.
In some cases, it is necessary to wear both a collar and a blanket at the same time (for example, in the case of an extensive skin defect after a unilateral mastectomy, when the blanket does not cover all the sutures applied and additional protection is required).
Repeated appointment and additional tests
Repeated appointments after surgery are scheduled individually. If the operation was planned and sutures were placed, then most often the sutures are removed at the next visit. It is prescribed on the 10-14th day.
If the operation was an emergency or was accompanied by any inflammatory process(for example, pyometra, gastric volvulus, foreign body in the intestine), a repeat appointment is scheduled on the 3-4th day after surgery. In this case, carry out:
- blood tests ( general analysis, blood biochemistry);
- examination by the attending physician.
All this will help to adjust therapy if necessary.
When performing operations on the spinal cord or brain, the animal is always kept in hospital for the first day (possibly more). In the morning, the patient is examined by a neurologist, and only after that the animal is discharged home. Next appointment prescribed on the 3-4th day.
After osteosynthesis (stabilization of the fracture with an external fixation device), a second appointment with the surgeon and an x-ray are performed on the 14th day.
If the patient is given to the owners on the day of the operation, they must be warned that the animal is still weakened. The anesthesia completely leaves the body after 24 hours, so residual manifestations are possible. The paws may become slightly tangled, the body temperature may be slightly reduced, and mild nausea may occur. During this period, we ask you to ensure that the animal does not fall from anywhere and is in a place without drafts. It is allowed to feed with regular food (if there are no additional notes in the card about dietary nutrition), but the portions should be reduced during the first day.
As our surgeons say, postoperative care is sometimes more important than the operation itself. Its high-quality implementation is the key to a successful outcome and recovery!
As you already understand, the key to your pet’s recovery is the coordinated work of not only the clinic staff, but also your understanding, trust and direct participation in the preparation and recovery of the animal. If you have any questions, it is important not to be shy - call and ask! We are always happy to help and ready to answer any questions!
1. Study outpatient card animal. The presence of helminths and fleas causes weakening of the body, so before surgery it is necessary to carry out deworming and flea treatment. To minimize the risk of disease viral infections, the animal must be vaccinated. If your pet has chronic diseases held necessary treatment(sometimes it is required before surgery tissue therapy, blood transfusion, autohemotherapy, etc.).
- In advance, the owner must think about transporting the animal, prepare a place at home for placement and means of protecting the wound (collar, blanket, diaper).
- The place where the pet will be kept after surgery should be dry, comfortable, clean, and free from drafts.
- Often, after anesthesia, cats may have a desire to jump higher, since they still have little control over their actions, so it is important to limit their movements for a short period of time.
- After surgery, you should not place the animal on a chair, sofa or any other elevated place: trying to get up and walk, the animal, while still under the influence of anesthesia, may fall and get injured!
- It is better to start feeding with small portions, about a third of her usual diet. It is not recommended to eat meat in the first days after surgery, as it is quite a heavy food.
2. If necessary, a row is assigned additional research(general clinical and biochemical tests blood, ECG, radiography, urine and stool analysis). The set of previously mentioned measures helps to establish the degree of indications and contraindications for surgery, determine one or another method of pain relief, and the method of fixation.
3. Prescribing a diet, appropriate nutrition and care for animals. When performing surgical procedures, a fasting diet is required, which should last from 6 to 12 hours (average 12 hours), with unlimited access to water. Sometimes a cleansing enema is necessary.
Postoperative care
If your pet will be recovering at home (for example, in veterinary clinic there is no hospital, or you do not want to leave it and will take care of it yourself), then you need to pay attention to the following important points.
The operation may have consequences in the form of disruption of thermoregulation, and the animal may begin to feel very cold. To save the animal from this, put it in a warm place and cover it with a blanket. If the cat suffers from chills, you can cover it with bottles of heated water.
It happens that animals recover from anesthesia for a long time and lie with wide with open eyes. Then you need to bury them special remedy, such as saline solution, which will help save your pet from dry eyes.
Until the cat or dog finally comes to its senses, it is better not to feed it. Experts advise doing this no earlier than 24 hours after surgery. Water can be given after a few hours. If the animal cannot approach the bowl on its own, then you can give it something to drink through a syringe without a needle, or simply wet its nose.
During the first two days, the animal’s appetite often changes: the cat may refuse to eat at all, but if this period is prolonged and he feels very lethargic, then there is a reason to consult a veterinarian.
1. You can offer the operated animal food only after 24 hours. It should be easily digestible and not cause diarrhea (like milk) or constipation (like bones, dry food). Access to water must be unlimited.
2. Consult your doctor about treatment postoperative suture and its removal. It may be necessary to use an antibiotic - find out the exact dosage and frequency of administration and strictly follow all the doctor’s instructions.
3. Monitor your pet’s appetite, urination and defecation. This is very important indicators recovery process!
If something worries you, consult a doctor immediately!
Our pets' teeth are constantly attacked by microorganisms that enter oral cavity with food. These bacteria, together with pieces of stuck food, create plaque, which gradually acquires a dense consistency and becomes tartar.
Castration and sterilization are the most frequently performed operations in veterinary practice, aimed at artificially disrupting the reproductive capacity of the body.
Castration of a cat is a fairly frequently performed operation in veterinary practice, aimed at artificially disrupting the reproductive capacity of the body. Castration of a cat has a number of undeniable advantages. When cats start walking, they usually leave the house for several days, sometimes returning beaten and exhausted. Many animals get hit by cars and become infected with infectious diseases.
3. Preparing the animal for surgery.
A) Fixation technique - the dog’s muzzle is fixed by tying a loop under lower jaw and fixed behind the ears in the form of 8. The limbs are fixed using special belts on the operating table.
B) Preparation of the surgical field. Filonchikov's method 1. Shave the hair 2. Degreasing - the skin is treated with a gauze swab soaked in a 0.5% solution of ammonia. 3. Then the skin is treated twice (tanned and disinfected) with a 5% alcohol solution of iodine, first after technical cleaning, and then immediately before the incision. 4. Isolation from surrounding tissues.
C) Preparation of the hands of the surgeon and his assistants. Spasokukotsky-Kochergin method. For mechanical cleaning and deep degreasing of the skin, use a freshly prepared 0.5% solution of ammonia in hot water. Hands are washed alternately in two basins for 2.5 minutes or under a running stream using a gauze napkin. After repeated washing, the liquid in the basin should remain clear. If this is not the case, wash your hands again.
Disinfection and tanning of leather is carried out as follows: dry hands are treated with ethyl alcohol gauze pad for 3-5 minutes, and fingertips, subungual spaces and nail beds are lubricated with a 5% alcohol solution of iodine. Sterility up to 40 minutes.
A) The dog is placed on its stomach and secured with straps, an antipsychotic is applied and local anesthesia. In order to calm and partially relieve pain, the dog is injected intramuscularly with a 1% solution of chlorpromazine at a dose of 0.08 ml/kg body weight. Local anesthesia is performed. Why use a thin needle at the base? auricle From several points, infiltration anesthesia is performed circularly with a 0.25% solution of novocaine or the solution is injected under the skin on both sides of the auricle along the amputation line.
B) Operation technique: B ear canal insert a tampon to prevent bleeding. The skin of the shell is shifted as far as possible to its base and an appropriate ear brush is applied, having previously removed the hair in this area. The clamp must be applied with great care. At the same time, uniform pressure is applied to such a degree that the clamp does not move and prevent bleeding. The lower end of the brush should be below the ear pocket, and the upper end near the apex or at the border of the upper and middle third of the shell. With a sharp scalpel cut off the shell exactly along the outer edge of the flapper. The removed section of the shell serves as a template for the second side. The flare is carefully removed only after surgery on the other side or no earlier than 8-10 minutes.
Before removing the flare, an intestinal clamp is applied below, which prevents bleeding when suturing.
B) Suturing.
The skin along the amputation line is sutured with a thin thread, without catching the cartilage: first the skin is pierced inner surface auricle, and then the outer one. Knotted catgut sutures are applied, and the edges of the wound are covered with disinfectant ointment. After this, the ears are placed on the back of the head on a gauze pad and bandaged. On the 3-4th day, the bandage is removed, an inspection is made and a massage of the ears is prescribed. The stitches are removed on the 7th day.
5. Possible complication during surgery, measures for their prevention and elimination.
1. Suppuration. Antiseptics and antibiotics are used to prevent and eliminate suppuration. Sulfa amide preparations, iodine solutions, etc. are used.
2. Infection. To avoid infection, you must follow all the rules for preparing the operation. Sterilization is mandatory. surgical instruments, suture material. Preparation of hands and surgical field.
3. Healing by secondary intention.If healing occurs by secondary intention, repeat surgery. The subcutaneous fiber is removed and a situational suture is applied.
4. Dehiscence of sutures. If the dehiscence of sutures goes away without suppuration, they resort to re-suturing.
5. The occurrence of vomiting during surgery. To avoid vomiting, the dog is prescribed a 10-12 hour fasting diet.
After this operation, the dog meets the standards of its breed and is suitable for participation in exhibitions for purebred dogs.
7. Conclusion.
This operation makes it possible to give the dog an aesthetically pleasing beautiful view and allows you to meet the standards of your breed.
This operation should be performed on many working breeds of dogs that will later take part in exhibitions and competitions.
1. Introduction.
2.Anatomo - topographic data.
3.Preparation for surgery.
5. Possible complications during surgery, measures to prevent and eliminate them.
1. Post-operative stage.
2. Conclusion.
3. List of used literature.
SSAU named after. N.V. Vavilova Institute of Veterinary Medicine and Biotechnology.
Department: Surgery and
Obstetrics.
On the topic of; “Auricle amputation in dogs
2- 4 one month old, Amputatio auriculue.
I've done the work:
Student FVM
SARATOV 2001
Bibliography;
1.Kashin A.S. Prevention and control of bleeding in animals - M. Kolos 1987.
2. Kovalev M.I. Petrakov K.A. Workshop on operative surgery with basics topographic anatomy pets Mn. - Harvest 1991 136 pp.
3.Magda I.I. Itkin B.Z. Voronin I.I.
M. Agropromizdat 1990 – 333 pages.
4. Plakhotin M.V. Handbook of Veterinary Surgery. M. Kolos 1977
5. Shakalov K.I. Bashkirov B.A. Pavozhenko I.E.
Private veterinary surgery– M. Agropromizdat
orthopedic surgeon
Abdominal operations- these are operations performed on organs located in body cavities (abdominal, thoracic), delimited from external environment special protective barriers (peritoneum, pleura). During surgery, these barriers are inevitably violated, which requires special measures to comply with the rules of asepsis and antiseptics.
Abdominal operations comprise most surgical interventions in veterinary practice and are performed for a variety of indications. For example, with for preventive purposes(castration of cats and bitches), as diagnostic procedure(determining changes in organs and tissues and taking them for analysis) and as the main method of treatment (removal of tumors, foreign bodies intestines, surgery for gastric volvulus).
All abdominal operations have a specific execution algorithm and are performed under general anesthesia, since it is necessary to ensure complete anesthesia and immobility of the animal during the procedure.
Stages abdominal surgery, whether it is an operation on the abdominal organs or chest cavity, will be the following:
1. Performing a surgical approach.
2. Manipulation of organs and tissues
3. Layer-by-layer closure (suturing) of the wound.
Since owners most often ask questions about abdominal surgery in connection with the castration of cats and dogs, we will consider these stages using the example of removal of the uterus and ovaries in female dogs in the form of questions and answers.
Is spaying/neutering a dog an abdominal surgery?
Yes, because the uterus and ovaries are located in the abdominal cavity. In contrast, castration of male and female cats is not an abdominal operation.
Which access is best to use?
Typically, for castration of females, one of the approaches to the abdominal organs is used:
- midline incision along the “white line”
- lateral access.
Each method has advantages and disadvantages.
Access along the white line consists of sequential separation of tissues along the midline of the abdomen. So-called " white line"- the place where the muscles and fascia of the lateral abdominal walls connect. There are no vessels or nerve fibers here, so if the incision passes directly along this landmark, there is practically no bleeding. In order to castrate a female dog, an incision is made from the navel and below, approximately 10-15 cm (depending on the size of the dog). However, by extending the incision higher or lower, good visualization of all organs located in the abdominal cavity can be achieved, if necessary. When closing the wound, sutures are sequentially applied to the peritoneum and aponeurosis, subcutaneous tissue and skin. To prevent licking/removal of stitches, the animal must wear a blanket. Rare complication may become a postoperative hernia.
Lateral access is performed in the area of the iliac fossa. This technique is used in some foreign countries, especially when sterilizing stray animals, since the risk of hernia formation and suture licking is reduced to zero. These are the priorities when choosing this method, due to the inability to provide proper postoperative care for such animals. However, the technology has many disadvantages. Firstly, it is more traumatic compared to access along the white line. The lateral abdominal wall consists of 3 large muscles, the fibers of which must be crossed during access, and subsequently separate sutures are placed on each muscle. Secondly, the incision limits the range of manipulation of organs and tissues in the abdominal cavity and cannot be extended to improve visualization if necessary. In fact, in a large dog, through one side incision, only 1 ovary and uterine horn can be qualitatively removed; for the second ovary, another access must be made from the opposite side. Difficulties also arise when removing the cervix through the incision, as well as when controlling bleeding. Anomalies, pregnancy or inflammation detected during surgery require a transition to access via midline.
What happens during the operation itself?
Surgical approach - sequential cutting of the skin, subcutaneous tissue, muscles of the abdominal wall, peritoneum. After accessing the abdominal organs, the surgeon finds the uterus and ovaries. Next, ligatures (ligation) are applied to the ligaments and vessels of the ovaries located in the area of the left and right kidney, on wide ligament the uterus and uterine vessels, and the uterus itself is ligated behind its cervix, after which the entire organ is removed (ovariohysterectomy). Careful isolation and resection of these structures is necessary to avoid complications. Next, the surgeon examines the areas of the stumps to control bleeding and internal organs, located directly in the operation area, after which sequential suturing of the abdominal wound occurs. Even when performing such a routine procedure as castration of a female dog, the surgeon is required to have knowledge of anatomy, careful handling of tissues and professional mastery of technique.
What complications can there be?
As with any abdominal surgery, after ovariohysterectomy complications may arise, such as
- bleeding due to loosening/slipping of the ligature
- adhesive disease and peritonitis
- inflammation in the stump area.
With a well-performed operation, these complications are practically eliminated, but there are always risks associated with the individual characteristics of the animal.
In the area of the suture, a seroma may occur - an accumulation of serous fluid under the skin. Tight suturing of tissues and postoperative rest help prevent its formation, but in large dogs This complication is not rare and does not cause serious consequences for the health of the animal. Aspiration or drainage is required to eliminate the seroma.
Postoperative care.
When performing planned preventive operations on the abdominal organs under sterile conditions, the use of antibiotics is most often not required. postoperative period. Owners perform standard treatment of sutures 1-2 times a day, and the animal must wear a protective blanket until the sutures are removed. If for some reason postoperative care is not possible, permanent, cosmetic intradermal sutures can be used.
Laparoscopic method of castration of animals.
A method gradually being introduced into veterinary practice endoscopic operations on the abdominal organs is borrowed from humane medicine. The advantages of the technique, when the surgeon manipulates organs only with the help of special instruments, are considered to be less trauma to the soft tissues of the abdominal wall and rapid postoperative rehabilitation. To castrate a dog, about 3-4 small incisions (about 1 cm) are made, and the uterus and ovaries are removed under video camera control. However, if significant pathologies are detected or it is impossible to control bleeding from large vessels, the surgeon has to proceed to a conventional approach along the midline of the abdomen. Since small incisions are closed with 1-2 stitches, the animal does not need to wear a blanket, and stitches can be removed earlier. Laparoscopy also reduces the risk of abdominal wall hernias.
At the veterinary clinic White Fang"When castrating females, we adhere to the following rules:
- Preoperative examination to exclude problems with the health of the animal.
- 12 hour fasting diet before surgery
- Performing a median approach for routine castration. It is also possible to perform endoscopically assisted surgery at the request of the owners.
- Complete removal uterus and ovaries in dogs.
- Layer-by-layer suturing of the wound with interrupted sutures. (It is possible to use a cosmetic seam at the request of the owners).
- The dog wears a protective blanket. The stitches are removed after 10-12 days.
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