Neutering and ligation

Neutering and ligation

1. Cat spay

   • Flank : routinely in UK (97%). Pros - fast, shorter recovery. Cons - if it goes wrong, would have to convert to midline.
     • Left horn should be lying immediately below lateral abdominal wall
   • ventral midline : Pros - full access to abdomen to deal with any complications. Cons - slightly slower recovery.
     • Uterus lies above the colon and below the small intestine and bladder.
   • Anatomy - Uterus : 2 ovaries attached to dorsal body wall via suspensory ovarian ligaments, 2 uterine horns, 1 uterine body, 1 cervix. Other anatomy : bladder, small intestine, colon
   • 1. grasp first horn with dressing forceps. 2. Pull horn out until ovary exteriorised. 3. 3 clamp technique. 4. Tie ligature into groove of bottom clamp. 5. Cut suspensory/ovarian ligament between top and bottom clamps. 6. Remove middle clamp and check for bleeding by holding with tissue forceps.

2. Ligation of blood vessels :- Circumferential - one or two simple interrupted ligatures tied around a vessel, need sufficient pedicle to prevent ligature rolling off end, more secure by ligating in a groove by artery forceps. Halstead transfixed - more secure, only used with fine suture material. Modified fixed - enables use of thicker suture material.