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Fish can make excellent subjects for surgery if suitable measures are taken to cater for the patient’s aquatic lifestyle. The decision to proceed to surgery in clinical cases can be motivated by rarity of the species involved, economic value of the patient or the owner’s emotional attachment. This chapter reviews anatomy, anaesthesia, presurgical investigation, preoperative preparation, techniques, wound closure, postoperative care and surgical procedures.

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Image of Figure 31.1
Figure 31.1 An operating microscope and microsurgical instruments are used to close a ventral midline incision in a gourami weighing 8 g. The fish is positioned in a V-shaped foam tray and covered with a clear plastic surgical drape.
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Figure 31.2 Self-retaining retractors facilitate adequate exposure to internal organs. Here, a ventral midline approach is used to remove an undifferentiated sarcoma from a koi. (Courtesy of Greg Lewbart.)
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Figure 31.3 Debridement of a body ulcer in a young koi. (a) Loose scales and necrotic tissue are removed using scissors and forceps. A drape covers the eyes and protects them from the glare of the operating lights. (b) Dilute povidone–iodine is applied to the ulcer with cotton buds to ensure thorough disinfection of the site. (c) A waterproof paste is applied to the ulcer to provide temporary sealing of the wound and help to retain some of the skin disinfectant. (© W.H. Wildgoose.)
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Figure 31.4 Ulceration on the face of an adult koi following injury from a dog bite. (a) This photograph was taken 2 weeks after initial debridement of the wound. Epithelialization has covered most of the wound, which appears less inflamed as a result. (b) The same fish photographed 16 weeks later, showing complete healing of the site. Restoration of normal pigmentation is a slow process and the final coloration may be unpredictable. (© W.H. Wildgoose.)
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Figure 31.5 (a) A papilloma on the top lip of an adult mirror carp, which interfered with normal feeding and respiration. It was not possible to excise the whole lesion, due to attachment to the underlying cartilage around the mouth. (b) The same fish photographed 4 weeks later. The remaining epidermal hyperplasia on the lip did not cause problems during feeding and resolved over several months. (© W.H. Wildgoose.)
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Figure 31.6 Lip fibromas in freshwater angelfish may interfere with normal feeding. Wide excision is not always achievable or necessary, since debulking the lesion can restore normal functional morphology, and recurrence is rare.
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Figure 31.7 (a) Preparation for midline abdominal surgery. Any excess body mucus is removed and dilute povidone–iodine solution is applied. Large scales, where present, are plucked from the incision line with forceps. (b) A ventral midline incision is made with a scalpel and extended caudally to the pelvis. (c) The pelvic girdle of a goldfish. This simple bony structure is embedded in the muscles of the body wall and joined in the midline by a fibrous junction. In old fish, the bones become ossified and fused together. (d) After sectioning the pelvis, the midline incision is extended towards the vent. Retractors improve visualization and access to the internal organs. (e) Closure of the muscle layer with absorbable monofilament suture material using a continuous suture pattern. (f) Closure of the skin with non-absorbable monofilament suture material using a simple interrupted suture pattern. The sutures are removed after 3–4 weeks. (© W.H. Wildgoose.)
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Figure 31.8 (a) An 8-year-old goldfish with a large fibroma involving most of the eye. The tumour had increased in size over a period of 3 months and was removed by enucleation. (b) Heat cauterization was used to control haemorrhage following the enucleation. The empty socket was packed with a waterproof paste and the fish was given systemic antibacterial treatment. (c) The fish was examined 20 months later: the original socket had become a shallow depression, with some resorption of the surrounding facial bone. There was no pigmentation at the surgical site.
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Figure 31.9 The pseudobranch (arrowed) of a striped bass is located in the dorsal opercular cavity. Pseudobranchectomy is one potential treatment for idiopathic gaseous exophthalmos.
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