Neutering + Ligation

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Neutering + Ligation

Summarise the different types of neutering procedure and the anatomy involved

Neutering

Castration = neutering of male

Orchidectomy

Spaying =neutering of female

Ovarioectomy / Ovariohysterectomy

Why?

Health

Pyometra - uterus removal only treatment

Prostatic disease

Prevent mammary cancer

Ovary removal

Caused by oestrogen levels

Behaviour

Testosterone anger source??

Anger often learnt

Contraception

Earlier the better

Anatomy

Uterus

Ovaries

Suspensory ligament

Ovarian ligaments

Uterine horns

Uterine body

Cervix

Bladder

Small intestine

Colon

Describe the cat spay procedure using a ventral mid-line approach

Bitch spay technique

Pros

Full access to abdo

Easier to see if already spayed

Cons

Slower

Longer convalescence

Anatomy

Uterus above colon

Uterus below SI + bladder

Visible

Bladder

SI

Colon

Method

Locating uterus

Displace bladder caudally

Displace SI cranially

Uterus on top of colon

Grasp first horn w dressing forceps

NOT tissue - puncture abdo organs

Pull horn out until ovary exteriorised

Ligate ovarian + suspensory ligaments

3 clamp technique

Ligature into groove left by bottom clamp

Remove ovary / horn

Cut ligament between middle + top clamps

Check for bleeding

Grip ovarian pedicle w tissue forceps +release bottom clamp

Tight enough = no bleeding

Repeat for other ovaries

Pull uterine horns caudally exposing cervix

Double clamp cervix

Ligate below clamps

Cut cervix between clamps

Check for bleeding

Describe the cat spay procedure using a flank approach

Cat spay technique

Pros

Fast

Short convalescence

Less likely to rip stitches

Cons

If something goes wrong you have to convert to midline

Cant see anatomy

Anatomy

Same anatomy but on side

Method

Find left horn

Immediately below lateral abdo wall incision

Once you've found first horn approach is same as midline approach

Transfix ligature

In cat cut below uterine horns - hard to distinguish body + cervix

Describe the advantages + disadvantages of the different ligation techniques

Ligation - prevent haemostasis

Circumferential

One / Two ligatures tied around vessel

Need sufficient pedicle to prevent rolling

Made more secure by groove

3 clamp technique

Halstead transfixed

More secure

Fine suture material

Modified transfixed ligature

Thicker suture material