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Principles of abdominal surgery

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Abstract

Abdominal surgery is a commonplace procedure in modern veterinary practice and one that most veterinary surgeons feel confident in their ability to perform. This chapter covers the indications for abdominal surgery, patient evaluation, preparation and stabilization, surgical risks and complications, and patient monitoring. Practical tips are highlighted throughout.

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Figures

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1.5 Manual platelet counts (shown with platelet clumping), activated clotting time (ACT), activated partial thromboplastin time (aPTT), prothrombin time (PT) and buccal mucosal bleeding time, in addition to specific factor estimation, all provide valuable information about a patient’s haemostatic ability. (© Alison Ridyard)
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1.6 Patient evaluation for the presence of pulmonary metastatic disease is important prior to abdominal surgery in the treatment of neoplastic diseases.
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1.7 Thoracocentesis to remove pleural effusion prior to general anaesthesia and abdominal surgery in a dog with a chronic traumatic diaphragmatic rupture.
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1.8 Abdominocentesis prior to abdominal surgery aided in the diagnosis of uroperitoneum in this patient.
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1.10 Placement of a jejunostomy tube during abdominal surgery, allowing enteral nutritional support in the postoperative period in a patient with a pancreatic abscess.
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1.13 An intra-abdominal abscess (delineated by a dashed line) following splenectomy in a German Shepherd Dog. The abscess developed at the site of ligation of the splenic artery and vein. The dog had a 3-week history of lethargy, inappetence and diarrhoea following the initial surgery.  was cultured from the abscess.
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1.15 Exploration of the abdominal cavity.
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1.16 (a) A wide surgical clip has been performed prior to exploratory abdominal surgery in a dog. (b) An inadequate surgical clip was performed in this dog. Note that the cranial part of the abdominal incision stops within the hair coat (arrowed).
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1.17 The scalpel blade should be held perpendicular to the skin.
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1.18 A Harmonic scalpel being used to dissect the skin away from a mandible. The active blade (arrowed) vibrates at 55,000 cycles per second.
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1.19 Moist abdominal swabs may be used to minimize tissue dehydration when operating on isolated tissues, such as this section of jejunum.
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1.21 Evisceration following ovariohysterectomy.
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1.22 A surgical swab retained following exploratory abdominal surgery.
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1.23 All surgical swabs should be accounted for prior to abdominal closure. Note the presence of the radiopaque marker in the swabs.
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