Contributors: Kyle Mathews

 Species: Canine   |   Classification: Techniques

Introduction Requirements Preparation Procedure Aftercare Outcomes Further Reading


  • Access to abdominal (also potentially thoracic and pelvic) cavity.


  • Treatment of various lesions (almost all abdominal organs can be exposed optimally).
  • Investigation when other options are unavailable or inconclusive.


  • Access to pelvic organs: extension via pubic symphysiotomy.
  • Access to thoracic organs: extension via sternotomy or diaphragmatic incision.
  • Allows full assessment of entire abdomen.
  • Fast and usually avascular approach.
  • Can improve access to craniodorsal abdomen with paracostal extension (rarely indicated).

Alternative Techniques

Decision Taking

Criteria for choosing test

  • Always briefly discuss specific surgical risks before surgery with the owner.
  • Clear advice on possible adverse sequelae is more effective before surgery and if given in writing.


Materials Required

Minimum equipment

Ideal equipment

  • Self-restraining retractor (Balfour Surgical instruments self-retaining retractors - Balfour abdominal or Gossett).


Dietary Preparation

  • Starvation 12 hours before to avoid reflux esophagitis.

Site Preparation

  • Clip and prepare (clip, scrub) sufficient area to allow extension incision if required Laparotomy 01 prepare the operation site.
  • Drape to allow minimal skin exposure lateral to incision Laparotomy 02 apply skin drapes Laparotomy 03 skin towel in place.




Step 1 -

  • Dorsal recumbency.

Step 2 -

  • Midline incision through skin and subcutis Laparotomy 04 incise the skin Laparotomy 05 cauterize cutaneous vessels.
    Count sponges before cutting - sponges with radiopaque markers are preferred.

Step 3 -

  • Identify linea alba, which appears as trough between 2 rectus muscles, with minimum of blunt dissection/undermining Laparotomy 06 dissect subcutaneous tissue.
  • In male, if access to caudal abdominal or intrapelvic structures is required:
    • Caudal incision paramedian around penis, prepuce.
    • Cut subcutaneous preputial muscles.
    • Reflect penis, prepuce laterally.
    • Ligate branches of external pudendal vessels.

Step 4 -

  • Raise linea alba, penetrate with stab incision Laparotomy 07 incise the linea alba.
    Use guarded scalpel blade..
  • Using scissors, or scalpel with Brodie director, extend cranial and caudal as required, incising linea and underlying peritoneum Laparotomy 08 resect along linea alba Laparotomy 09 completed laparotomy incision.
  • Avoid underlying viscera by continuing to elevate linea alba and/or placing finger or grooved director within abdomen under line of incision.
  • Ligate/cauterize small vessels.
    If using retractor protect exposed tissues with saline soaked swabs..
  • Extend with sternotomy or pubic symphysiotomy if necessary, or with paracostal incision.



Step 1 -

  • Close body wall in single layer Laparotomy 11 close the body wall.
    Inclusion of peritoneum increases incidence of adhesions..
  • Include only external rectus sheath Laparotomy 12 complete the suturing.

Step 2 -

  • Simple continuous suture of monofilament nylon, polypropylene, polyglactin or polydioxanone is rapid and secure.
    Use simple interrupted technique if chromic catgut used..
  • Use taper cut needle.
  • Variable size suture material:
    • 3/0 small dogs.
    • 2/0 small - medium dogs.
    • 0 medium - large dogs.

Step 3 -

  • Simple continuous suture, with fine absorbable material, in subcutis.

Step 4 -

  • Routine skin closure:
  • Close subcutaneous layer Laparotomy 13 close the subcutaneous layer.
  • Simple interrupted or cruciate.
  • Appose skin edges Laparotomy 14 appose the cutaneous wound Laparotomy 15 close the skin wound.
  • Should be possible to lift knot easily, ie not too tight.
  • Alternative: subcuticular buried pattern.





Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Rosin E & Richardson S (1987) Effect of fascial closure technique on strength of healing abdominal incisions in the dog. A biomechanical study. Vet Surg 16 (4), 269-272 PubMed.
  • Rosin E (1985) Single layer, simple continuous suture pattern for closure of abdominal incisions. JAAHA 21 (6), 751-756 VetMedResource.
  • Crowe D T Jr. (1978) Closure of abdominal incisions using a continuous polypropylene suture - clinical experience in 550 dogs and cats. Vet Surg (3), 74-77 Wiley Online Library.