Contributors: Ed Hall, Joseph Harari
Species: Feline | Classification: Techniques
Introduction Requirements Preparation Procedure Aftercare Outcomes Further Reading
Introduction
- Access to abdominal cavity (infrequently in the USA).
Uses
- Treatment of various lesions, eg kidney stones Urolithiasis, gastric FBs.
- Investigation if other options unavailable or inconclusive.
- Gastrotomy tube placement Gastrostomy: percutaneous tube (endoscopic).
- Gastric decompression.
- Ovariohysterectomy - unless possible coat color change at site may be unacceptable to owner, or large exposure indicated Ovariohysterectomy.
- Adrenal surgery (primarily in the USA).
- Kidney biopsy.
Advantages
- Muscle splitting approach may reduce risk of dehiscence if tissue healing poor.
- Good unilateral access to organs placed dorsally in the abdomen.
Disadvantages
- Limited access to restricted areas.
- Hair regrowth at site may be darker in color - this may be unacceptable to some owners, eg in show animals - ventral midline approach may be a suitable alternative.
Alternative Techniques
- Midline Laparotomy: midline.
- Paracostal Laparotomy: paracostal.
- Paramedian Laparotomy: paramedian.
Decision Taking
Criteria for choosing test
- Midline laparotomy is usually preferred technique since it allows a full assessment of abdominal organs.
Requirements
Materials Required
Minimum equipment
- Standard kit Surgical instruments.
Ideal equipment
- Self-restraining retractor (Balfour or Gossett
).
Preparation
Dietary Preparation
- Fast patient for 12 hours before to avoid reflux esophagitis Esophagitis.
Restraint
- General anesthesia General anesthesia: overview.
- Occasionally performed under sedation and infiltration with local anesthetic.
Procedure
Approach
Step 1 - Position patient
- Lateral recumbency, (left or right according to access required).
Step 2 - Incise skin
- Vertical skin incision extending dorsally or ventrally according to exposure required.
Step 3 - Blunt dissection of muscles
- Open each muscle layer by blunt dissection in direction of fibers.
Core Procedure
- Further surgery depends on core procedure.
Exit
Step 1 - Close muscle layers
- Close muscle in layers using monofilament nylon, polypropylene, polygalactin, polydioxanone or chromic catgut using a simple continuous pattern.
Suturing peritoneum may increase risk of adhesions.
Step 2 - Close skin
- Routine skin closure.
Aftercare
Immediate
Analgesia
- Essential Analgesia: overview.
Outcomes
Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.