Contributors: Joseph Harari
Species: Canine | Classification: Techniques
- Access to abdomen Laparotomy: midline (infrequently in the USA).
- Treatment of various lesions, eg kidney stones, gastric foreign bodies.
- Investigation if other options unavailable or inconclusive.
- Gastrotomy tube placement Gastrostomy: percutaneous tube 1 (endoscopic).
- Gastric decompression Stomach: gastric dilatation / volvulus (GDV) syndrome.
- Ovariohysterectomy Ovariohysterectomy.
- Adrenal surgery (primarily in the USA).
- Kidney biopsy.
- Muscle splitting approach may reduce risk of dehiscence if tissue healing poor.
- Good unilateral access to organs placed dorsally in the abdomen.
- Limited access to restricted areas.
- Midline Laparotomy: midline.
Criteria for choosing test
- Midline laparotomy is usually preferred technique since it allows a full assessment of abdominal organs.
- Standard kit Surgical instruments.
- Self-restraining retractor (Balfour or Gossett).
- Starvation 12 hours before general anesthesia to avoid reflex esophagitis.
- General anesthesia General anesthesia: overview.
- Occasionally performed under sedation and infiltration with local anesthetic.
- Laparotomy Laparotomy: midline
Step 1 - Skin incision
- Skin incision
Step 1 - Muscle incision
- Open each muscle layer by blunt dissection in direction of fibers.
Step 1 - Closure
- Close muscle in layers using monofilament nylon, polypropylene, polyglactin, polydioxanone or chromic catgut using a simple continuous pattern.
Suturing peritoneum may increase risk of adhesions.
Step 2 - Skin closure
- Routine skin closure Wound closure: primary.