1887
Exploratory laparotomy
British Small Animal Veterinary Association , 157 (2013); https://doi.org/10.22233/9781910443163.13
/content/chapter/10.22233/9781910443163.chap13
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Exploratory laparotomy

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Abstract

Urinary tract surgery can be technically demanding in rabbits due to their relatively small size and unique anatomy. Some techniques, however, such as cystotomy, are relatively common and fairly straightforward procedures. This chapters assesses Anatomy of the urinary tract; Patient assessment and decision-making; Hypercalciuria and urolithiasis; Lower urinary tract disease; Medical management of urinary tract disease; Surgical considerations and specialist equipment; Surgical procedures; and Postoperative care. : Nephrectomy; Cystotomy.

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Figures

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13.1
The normal anatomy of the abdomen: left lateral view; Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. right lateral view. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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13.1 The normal anatomy of the abdomen: left lateral view; Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. right lateral view. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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13.2
Mass adherent to bladder wall, causing persistent haematuria. © 2013 British Small Animal Veterinary Association
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13.2 Mass adherent to bladder wall, causing persistent haematuria.
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13.3
Exploration of adhesions involving the bladder. Note the use of suction to avoid abdominal contamination with urine. © 2013 British Small Animal Veterinary Association
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13.3 Exploration of adhesions involving the bladder. Note the use of suction to avoid abdominal contamination with urine.
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13.4
The caecum has been exteriorized to investigate chronic distension and avoid contamination of the abdomen, but must be kept warm and moist and re-placed carefully. © 2013 British Small Animal Veterinary Association
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13.4 The caecum has been exteriorized to investigate chronic distension and avoid contamination of the abdomen, but must be kept warm and moist and re-placed carefully.
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13.5
Adhesion formation between cervical stump and gastrointestinal tract. (Courtesy of Ron Rees Davies) © 2013 British Small Animal Veterinary Association
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13.5 Adhesion formation between cervical stump and gastrointestinal tract. (Courtesy of Ron Rees Davies)
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13.6
This rabbit had a mass of adhesions throughout the abdomen, involving the gastrointestinal tract and urogenital tract in particular. © 2013 British Small Animal Veterinary Association
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13.6 This rabbit had a mass of adhesions throughout the abdomen, involving the gastrointestinal tract and urogenital tract in particular.
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13.7
The abdominal viscera are covered in warm moist swabs when exposed during surgery. © 2013 British Small Animal Veterinary Association
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13.7 The abdominal viscera are covered in warm moist swabs when exposed during surgery.
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13.8
This abscess followed scrotal castration and postoperative infection. On a thorough examination of the abdominal cavity, further abscesses were found , but not generalized peritonitis. © 2013 British Small Animal Veterinary Association
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13.8 This abscess followed scrotal castration and postoperative infection. On a thorough examination of the abdominal cavity, further abscesses were found , but not generalized peritonitis.
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The linea alba is tented away from the viscera and carefully incised.
The linea alba is tented away from the viscera and carefully incised. © 2013 British Small Animal Veterinary Association
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Image of The linea alba is tented away from the viscera and carefully incised.
The linea alba is tented away from the viscera and carefully incised. The linea alba is tented away from the viscera and carefully incised.
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The incision is carefully extended with Metzenbaum scissors.
The incision is carefully extended with Metzenbaum scissors. © 2013 British Small Animal Veterinary Association
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Image of The incision is carefully extended with Metzenbaum scissors.
The incision is carefully extended with Metzenbaum scissors. The incision is carefully extended with Metzenbaum scissors.
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© 2013 British Small Animal Veterinary Association
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This incision was made from just below the xiphisternum to midway between the umbilicus and the pubis, and is sufficient for most abdominal surgery. The Lone Star retractor is used to further improve access and visibility. However, smaller incisions are advised, where possible, to minimize surgical time, adhesion risk and postoperative pain, and to minimize the risks and severity of wound breakdown subsequently.
This incision was made from just below the xiphisternum to midway between the umbilicus and the pubis, and is sufficient for most abdominal surgery. The Lone Star retractor is used to further improve access and visibility. However, smaller incisions are advised, where possible, to minimize surgical time, adhesion risk and postoperative pain, and to minimize the risks and severity of wound breakdown subsequently. © 2013 British Small Animal Veterinary Association
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Image of This incision was made from just below the xiphisternum to midway between the umbilicus and the pubis, and is sufficient for most abdominal surgery. The Lone Star retractor is used to further improve access and visibility. However, smaller incisions are advised, where possible, to minimize surgical time, adhesion risk and postoperative pain, and to minimize the risks and severity of wound breakdown subsequently.
This incision was made from just below the xiphisternum to midway between the umbilicus and the pubis, and is sufficient for most abdominal surgery. The Lone Star retractor is used to further improve access and visibility. However, smaller incisions are advised, where possible, to minimize surgical time, adhesion risk and postoperative pain, and to minimize the risks and severity of wound breakdown subsequently. This incision was made from just below the xiphisternum to midway between the umbilicus and the pubis, and is sufficient for most abdominal surgery. The Lone Star retractor is used to further improve access and visibility. However, smaller incisions are advised, where possible, to minimize surgical time, adhesion risk and postoperative pain, and to minimize the risks and severity of wound breakdown subsequently.
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A Lone Star retractor used to improve exposure in a cranial laparotomy incision, giving good access to all but the deeper organs. Extension of the incision caudally would improve exposure further, but in deep-chested breeds, access to the dorsal viscera can be challenging. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
A Lone Star retractor used to improve exposure in a cranial laparotomy incision, giving good access to all but the deeper organs. Extension of the incision caudally would improve exposure further, but in deep-chested breeds, access to the dorsal viscera can be challenging. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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Image of A Lone Star retractor used to improve exposure in a cranial laparotomy incision, giving good access to all but the deeper organs. Extension of the incision caudally would improve exposure further, but in deep-chested breeds, access to the dorsal viscera can be challenging. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
A Lone Star retractor used to improve exposure in a cranial laparotomy incision, giving good access to all but the deeper organs. Extension of the incision caudally would improve exposure further, but in deep-chested breeds, access to the dorsal viscera can be challenging. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. A Lone Star retractor used to improve exposure in a cranial laparotomy incision, giving good access to all but the deeper organs. Extension of the incision caudally would improve exposure further, but in deep-chested breeds, access to the dorsal viscera can be challenging. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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A loop of absorbable suture material is placed around the tip of a liver lobe.
A loop of absorbable suture material is placed around the tip of a liver lobe. © 2013 British Small Animal Veterinary Association
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Image of A loop of absorbable suture material is placed around the tip of a liver lobe.
A loop of absorbable suture material is placed around the tip of a liver lobe. A loop of absorbable suture material is placed around the tip of a liver lobe.
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The suture is tied tightly and an empty suture packet is placed below the tip of the liver to act as a ‘cutting board’. The hepatic tissue is cut approximately 5 mm from the ligature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The suture is tied tightly and an empty suture packet is placed below the tip of the liver to act as a ‘cutting board’. The hepatic tissue is cut approximately 5 mm from the ligature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2013 British Small Animal Veterinary Association
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Image of The suture is tied tightly and an empty suture packet is placed below the tip of the liver to act as a ‘cutting board’. The hepatic tissue is cut approximately 5 mm from the ligature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The suture is tied tightly and an empty suture packet is placed below the tip of the liver to act as a ‘cutting board’. The hepatic tissue is cut approximately 5 mm from the ligature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. The suture is tied tightly and an empty suture packet is placed below the tip of the liver to act as a ‘cutting board’. The hepatic tissue is cut approximately 5 mm from the ligature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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The biopsy sample and suture packet can then be handed to a non-sterile assistant to be frozen or put into formalin.
The biopsy sample and suture packet can then be handed to a non-sterile assistant to be frozen or put into formalin. © 2013 British Small Animal Veterinary Association
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Image of The biopsy sample and suture packet can then be handed to a non-sterile assistant to be frozen or put into formalin.
The biopsy sample and suture packet can then be handed to a non-sterile assistant to be frozen or put into formalin. The biopsy sample and suture packet can then be handed to a non-sterile assistant to be frozen or put into formalin.
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A diseased liver lobe (in this case an accessory lobe) is identified and exteriorized.
A diseased liver lobe (in this case an accessory lobe) is identified and exteriorized. © 2013 British Small Animal Veterinary Association
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Image of A diseased liver lobe (in this case an accessory lobe) is identified and exteriorized.
A diseased liver lobe (in this case an accessory lobe) is identified and exteriorized. A diseased liver lobe (in this case an accessory lobe) is identified and exteriorized.
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The required section (in this case an entire diseased lobe) is isolated with haemostats. Note the retractors used to improve access in this deep-chested breed.
The required section (in this case an entire diseased lobe) is isolated with haemostats. Note the retractors used to improve access in this deep-chested breed. © 2013 British Small Animal Veterinary Association
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Image of The required section (in this case an entire diseased lobe) is isolated with haemostats. Note the retractors used to improve access in this deep-chested breed.
The required section (in this case an entire diseased lobe) is isolated with haemostats. Note the retractors used to improve access in this deep-chested breed. The required section (in this case an entire diseased lobe) is isolated with haemostats. Note the retractors used to improve access in this deep-chested breed.
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A suture is preplaced through the parenchyma and over the haemostats after removal of the tissue.
A suture is preplaced through the parenchyma and over the haemostats after removal of the tissue. © 2013 British Small Animal Veterinary Association
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Image of A suture is preplaced through the parenchyma and over the haemostats after removal of the tissue.
A suture is preplaced through the parenchyma and over the haemostats after removal of the tissue. A suture is preplaced through the parenchyma and over the haemostats after removal of the tissue.
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