SurgLEC FE: Surgery of the Reproductive System

Ovariohysterectomy (OHE)

surgical removal of the ovaries and uterus

Ovariectomy (OVE)

surgical removal of the ovaries alone

Orchiectomy

surgical removal of the testicles

Castration

refers to removal of either the male or female sex organs ,but it is most commonly used interchangeably for orchiectomy.

Mastectomy

excision of one or more mammary glands or mammary tissues.

Episiotomy

incision of the vulvar orifice to expose the vulva and vagina

Episioplasty or vulvoplasty

reconstruction of the vulva

Prostatectomy

removal of all or a portion of the prostate gland

Hysterotomy

surgical incision into the uterus (e.g. Cesarean Section)

7

Early gonadectomy is safe in dogs and cats over __ weeks of age.

3

Female dogs are at greater risk of urinary incontinence if ovariohysterectomy is performed before __ months of age

8 to 9

Growth plate closure is delayed by __ weeks resulting in increased long bone length

Closed Pre scrotal Castration

performed similarly to the “open “ technique except that the parietal vaginal tunics are not incised

Perineal Castration

make a midline skin and subcutaneous tissue incision dorsal to the scrotum in the perineum ventral to the anus. Advance one testicle to the incision and incise the spermatic fascia and tissue.

Scrotal Ablation

necessary for neoplastic scrotal diseases and for castration performed in conjunction with scrotal urethrostomy in dogs and perineal urethrostomy in cats

Elective CS

often scheduled for brachycephalic breeds and other animals with a history of dystocia or those with pelvic fracture malunion

1. Boston terrier

2. English and French bulldogs

3. Mastiffs

4. Scottish terriers

Breeds with high frequency of CS include but are not limited to:

Naloxone

Place a drop of __ under the tongue

Doxapram

Give ___ (place a drop under the tongue) to stimulate respiration

32C,90F

Place neonates in a warm environment (___) until their mother is able to care for them

MASTECTOMY

Removal of the mammary gland(s) is usually performed to remove tumors.

Simple mastectomy

excision of one gland

Regional mastectomy

excision of several glands

Complete unilateral mastectomy

excision of the entire chain

Episiotomy

is an incision of the vulvar orifice to allow access to the vestibule and vagina.

Lumpectomy

removal of a mass or part of mamma

Unilateral mastectomy

removal of all mammary glands, subcutaneous tissues and associated lymphatics on one side of the midline

Bilateral mastectomy

simultaneous removal of both mammary chains

Leiomyoma and Leiomyosarcoma

benign and malignant smooth muscle tumors respectively that it may occur in the uterus

Uterine adenocarcinomas

malignant tumors of the uterine glands

Pyometra

is an accumulation of purulent material within the uterus,referred to as cystic endometrial hyperplasia-pyometra complex

Hydrometra

uterine distension with sterile fluid(watery secretion)

Mucometra

mucoid secretion

Hematometra

bloody secretions

Stump pyometra

accumulation of purulent material in the vestige of the uterus that remains after OHE

Vaginal prolapse/hyperplasia

occurs during estrous or proestrous as a result of edematous enlargement of vaginal tissue

Vaginal prolapse

involves the 360-degree protrusion of mucosa

Vaginal hyperplasia

may originate from a stalk of mucosa on the floor of the vagina, both usually cranial to the urethral papillae

UTERINE PROLAPSE

Is an inversion and protrusion of a portion of the uterus through the cervix into the vagina during or near parturition

Prostatic Hyperplasia

is a benign enlargement of the prostate

Prostatic abscesses

localized accumulation of purulent material within the prostate parenchyma.

Prostatitis

infection of the prostate gland with or without abscess formation.

Prostatic omentalization

is currently the treatment of choice for abscess drainage.

Subtotal prostatectomy

is an option if abscess recur

Neutering

is performed to prevent or alter behavioral abnormalities and to reconstruct traumatized or malformed tissue

large-breed dogs

In which breed of dogs does increased risk for excessive tibial plateau angle occur

6 to 8

Penis, prepuce and vulva may appear small and infantile if neutered at ___ weeks

1. Ovariohysterectomy 2. Castration 3. Cesarian section 4. Cryptorchid castration 5. Mastectomy 6. Scrotal ablation 7. Episiotomy 8. Vasectomy 9. Episioplasty 10. Prostatic drainage 11. Prostatectomy 12. Penile amputation 13. Preputial reconstruction 14. Phallopexy 15. Biopsy

15 surgical procedures of the Reproductive Tract

mammary tumors

Most common reason to perform OHE or OVE Part 1: Prevent estrous and unwanted offspring + Prevention of ___ or congenital anomalies

pyometra

Most common reason to perform OHE or OVE Part 2: Prevention and treatment of ___ ,metritis , neoplasia (ovarian, uterine, vagina ), cysts, trauma, uterine torsion, uterine prolapse, subinvolution of placental sites, vaginal prolapse, vaginal hyperplasia

diabetes

Most common reason to perform OHE or OVE Part 3: Control of some endocrine abnormalities (___and epilepsy) and dermatoses (e.g. generalized)

2 to 3

In OVARIOHYSTERECTOMY procedure, Elevate the abdominal wall with thumb forceps and slide the ovariectomy hook against the abdominal wall, ___ cm caudal to the kidney.

caudolateral

In OVARIOHYSTERECTOMY procedure, Stretch or tear the suspensory ligament to allow exteriorization of the ovary using the index finger to apply ___ traction on the suspensory ligament

caudomedial

In OVARIOHYSTERECTOMY procedure, Stretch or tear the suspensory ligament to allow exteriorization of the ovary using the index finger … maintaining ___traction on the uterine horn.

cats

In OVARIOHYSTERECTOMY procedure, Make the incision more caudal in which species to facilitate ligation of the uterine body?

Vicryl (synthetic absorbable material)

In OVARIOHYSTERECTOMY procedure, what is the recommended suture material for ligation of broad ligament if patient in estrus, pregnant, or vascular?

three clamp

In OVARIOHYSTERECTOMY procedure, repeat ___ technique for cervical ligature

stick ties and encircling

In OVARIOHYSTERECTOMY procedure, you can also use ___ and ___ in cervical ligature

fertility

Castration reduces overpopulation by inhibiting male ___

ORCHIECTOMY

Decreases male aggressiveness, roaming, and undesirable urination behavior.

androgen

ORCHIECTOMY it helps prevent ___-related diseases, including Prostatic diseases, Perianal adenomas, and Perineal hernias

1.Congenital abnormalities 2. Testicular or epididymal abnormalities 3. Scrotal neoplasia, trauma, or abscesses 4. Inguinal-scrotal herniorrhaphy 5. Scrotal urethrostomy 6. Epilepsy control 7. Control of endocrine abnormalities

7 Other indications of castration

Pre-scrotal approach

most common and more easily performed Canine Castration

perineal approach

Testicles are more difficult to exteriorize with a ___.

Scrotal

___ incisions are sometimes used when castrating prepubertal puppies

scrotal urethrostomy

Scrotal Ablation – necessary for neoplastic scrotal diseases and for castration performed in conjunction with ____ in dogs.

perineal urethrostomy

Scrotal Ablation – necessary for neoplastic scrotal diseases and for castration performed in conjunction with ____ in cats.

Cryptorchid Castration

congenital failure of the testicle(s)to descend into the scrotum.

fibrosis

Testes normally are pulled into the scrotum soon after birth by ___ and contraction of the gubernaculum

gubernaculum

Testes normally are pulled into the scrotum soon after birth by fibrosis and contraction of the ___

2 months

Dogs and cats are considered to have cryptorchidism if there is no testicular descent by ___ of age

Unilateral cryptorchidism

___ is more common type of cryptorchid

inguinal area or abdominal cavity

Cryptorchid testes may be in the____ or ____.

Bilateral castration

is recommended because the condition is considered to be a sex-linked autosomal recessive trait in dogs

sertoli cell tumors, seminomas

Retained canine testes are predisposed to neoplasia (____, ____)

exploratory or laparoscopy

Non palpable testis must be located via ___ or ____.

pre scrotal area

In Open Castration, Advance one testicle into the ___ by applying pressure over the scrotum. Make an incision over the testicle.

vaginal tunic

In Open Castration, Incise the spermatic fascia and parietal ___.

CLOSED PRE-SCROTAL CASTRATION

Although the risk ligature slippage and loosening may be slightly greater with closed than open technique , removal of the tunics may reduce postoperative swelling.

Stripping

dissection of scrotal fascia

1. Severe scrotal trauma 2. Abscesses 3. Ischemia 4. May improve the post castration appearance of the dog if they have a pendulous scrotum

SCROTAL ABLATION other indications

electrocoagulation

Control hemorrhage with ___, ligation or pressure.

elliptical skin

In SURGICAL PROCEDURE OF SCROTAL ABLATION, Make an ___ incision at the base of the scrotum , being careful not to excise too much skin

16 to 20; clippers

For FELINE CASTRATION, In kittens less than ___ weeks of age, plucking scrotal hair may be difficult. Use ___ to gently remove scrotal hair in these animals.

HYSTEROTOMY

aka Cesarean section

remove all fetuses from the gravid uterus as quickly as possible.

The goal of CS

actual or potential dystocia(oversized , mal positioned , or maldeveloped fetuses, small pelvic canal size, uterine inertia) or fetal putrefaction.

Primary indications for CS

dystocia

IN CS, Animals with ___often have fluid and electrolyte abnormalities that should be corrected before surgery.

prepartum eclampsia

IN CS, Usually a post partum problem, ___ causes hypocalcemia.

Prophylactic antibiotics

IN CS, ____ should be given if fetal death or uterine infection is suspected.

directly

Anesthetize these animals properly, fetal depression and decreased viability are ___ proportional to the degree of maternal depression.

second team

The disadvantage of this technique is that a ___ is required to resuscitate the neonates.

sterile towels or laparotomy pads.

In CS, Isolate the uterus from the remainder of the abdomen with ___ or ___

milking

In CS, Empty each horn by gently squeezing (____) cranial to each fetus to move it toward the incision ,then grasping and gently pulling it from the uterus

oxytocin

In CS, Administer if contractions has not occurred

1. Cleft palate 2. Limb deformity 3. Hernia 4. Imperforate anus

Inspect each neonate for congenital or developmental anomalies like:

perivulvar dermatitis and recurrent urinary tract infections

EPISIOPLASTY Reconstructive procedure most commonly performed to excise excess skin folds around the vulva, which cause ____ and ___

VULVOPLASTY

aka EPISIOPLASTY

Skin fold pyoderma

In EPISIOPLASTY, ___ should be treated medically before surgical reconstruction

1 old

Elective neutering is most advantageous when the animal is less than ___