Cystotomy and Laparoscopic Techniques

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Questions and Answers

What is the primary purpose of performing a vulval suture in cows?

To enhance mating performance

To prevent vaginal prolapse (correct)

To facilitate urine flow

To improve overall fertility

Which method is described as causing less discomfort to the patient during vulval suturing?

Single interrupted suture

Mattress-suture method

Cross-lacing method (correct)

Purse-string suture

What is the main indication for performing a medial patellar desmotomy in bovines?

Surgical correction of tendon injuries

Chronic lameness due to fractures

Upward fixation of the patella (correct)

Severe arthritis in the knee

How many straight ligaments of the patella are there in bovines?

Three Signup and view all the answers

What is the primary goal of a medial patellar desmotomy?

Mechanically bring down the patella Signup and view all the answers

What is the position of the animal during a medial patellar desmotomy?

Cast and secured in lateral recumbency Signup and view all the answers

In the cross-lacing method for vulval suturing, what material is used for the sutures?

Sterile umbilical tape Signup and view all the answers

Which ligament is cut during a medial patellar desmotomy?

Medial straight ligament Signup and view all the answers

What is the purpose of administering ammonium chloride after surgery?

To act as an acidifier Signup and view all the answers

When is clamping of the Foley's catheter initiated during the treatment protocol?

From day 5 Signup and view all the answers

What suture materials are used for closing the abdominal muscle layer and the skin?

Catgut for muscle and silk or nylon for skin Signup and view all the answers

What indicates the need for a cystotomy procedure?

Vesical calculi or neoplastic growth Signup and view all the answers

What is the primary method used to check for the patency of the urethra post-surgery?

Positive contrast cysto-urethrography Signup and view all the answers

What type of anesthesia is required for the cystotomy procedure?

General anesthesia Signup and view all the answers

What is the outcome expected after the removal of the Foley’s catheter?

Healing without complications Signup and view all the answers

What suture technique is used to close the incision on the bladder?

Cushing's inversion sutures Signup and view all the answers

What is the first step in severing the ligament during the surgical procedure?

Position the cutting edge towards the ligament Signup and view all the answers

Which method is particularly useful for uncooperative patients?

Lateral recumbency blind method Signup and view all the answers

During the open method, where is the linear incision made?

0.5 cm lateral to the medial patellar ligament Signup and view all the answers

What is used to manage the fascia during the open method procedure?

Artery forceps Signup and view all the answers

What is indicated by a deep depression between the cut ends of the ligament?

Successful severance of the ligament Signup and view all the answers

What is a common post-operative complication after surgical procedures on the ligament?

Penetration of the joint capsule Signup and view all the answers

What is the recommended post-operative care after the open method surgery?

Daily antiseptic dressing and antibiotic cover Signup and view all the answers

Which step is NOT part of the blind method in lateral recumbency?

Making a 3 cm incision on the limb Signup and view all the answers

What occurs when the patella is carried dorsally by slight manual pressure during a clinical examination?

The animal displays a locked gait Signup and view all the answers

Which ligaments connect the patella to the tibial tuberosity?

Patellar ligaments Signup and view all the answers

What is the most suitable site for skin incision during the procedure?

Close to the insertion of the medial ligament to the anterior tuberosity of the tibia Signup and view all the answers

In which direction does circling the animal with the affected limb outermost lessen symptoms?

Counter-clockwise Signup and view all the answers

Which type of anaesthesia is appropriate for this procedure?

Local infiltration anaesthesia or epidural anaesthesia Signup and view all the answers

What is a disadvantage of making an incision at Site No.2?

Increased chance of injury to articular vessels Signup and view all the answers

What should be applied to the operational site before making an incision?

Tincture of iodine Signup and view all the answers

What is the preferred local anaesthetic used during the surgery?

2% lignocaine Signup and view all the answers

What is the primary purpose of instilling Tr.Iodine into the incision?

To disinfect the wound Signup and view all the answers

During the blind method of surgery, where is the incision made?

Between the middle and medial patellar ligaments Signup and view all the answers

Which technique involves cutting through a longer incision?

Open technique Signup and view all the answers

What is the main drawback of Site No.3 for making an incision?

Higher risk of joint capsule injury Signup and view all the answers

What should be the orientation of the cutting edge when pushing the tenotom through the skin incision?

Vertical Signup and view all the answers

When using the closed technique, how is the scalpel positioned before cutting the ligament?

Flat-wise under the ligament Signup and view all the answers

What action should be taken if protruding fat tissue is observed during the procedure?

Snip it off Signup and view all the answers

What is the primary advantage of cystotomy for bladder stone removal?

It allows for the removal of all stone debris. Signup and view all the answers

Which method requires specialized instrumentation and experience to perform stone removal?

Laparoscopic cystotomy Signup and view all the answers

What is a significant risk associated with laparoscopic cystotomy?

Suturing techniques that can cause future stone formation. Signup and view all the answers

In what situation would tube cystostomy be most appropriately utilized?

For temporary urethral repair due to trauma. Signup and view all the answers

Which procedure is described as having a potential for lower risks compared to perineal urethrotomy?

Pararectal cystotomy Signup and view all the answers

What is a disadvantage of performing cystotomy in adult horses?

Difficulty accessing the bladder. Signup and view all the answers

What exactly does tube cystostomy involve?

Placement of a catheter into the bladder via a skin incision. Signup and view all the answers

Which of the following methods is most commonly used for bladder stone removal?

Standing removal in the field. Signup and view all the answers

Study Notes

Cystotomy

Bladder stone removal can be done through the urethra (standing) or via cystotomy (general anesthesia).
Gradual urethral dilation/sphincterotomy may assist stone removal in mares.
Male stones are often removed via perineal urethrotomy or perirectal incision.
Alternatives include stone-busting lasers, laparoscopy, and lithotripsy.
Standing removal is most common and possible in the field.

Laparocystotomy

Removal of stones via cystotomy under general anesthesia is the preferred method.
Allows intact stone removal, bladder wall culture, and complete debris removal.
Leaving debris can cause future issues.
Bladder access is difficult in adult horses.
Laparocystotomy is the most expensive option with a long recovery period.

Laparoscopic Cystotomy

Reported removal method, requiring experience and specialized equipment.
Stones need to be contained in a bag.
Closure is difficult to prevent lumen penetration and future stone formation.
Can handle stones up to 6-8cm.

Pararectal Cystotomy

Less common but potentially cost-effective for large cystic calculi.
Recent suggestion for lower risk than other procedures (PU).

Tube Cystostomy

A urinary diversion/urethral bypass technique.
A Foley's catheter is placed via a small incision into the bladder.
Used in urethral obstruction, rupture, or ruptured bladder in small ruminants.
Temporary or permanent, for urethral repair, acute urethral obstruction, or bladder cancer/neurogenic bladder atony.
Provides an avenue for cysto-urethrography.
Useful to assess issues like urethral obstruction, post-op healing, medical therapy evaluation, and when animal should urinate through the urethra.
Used as an avenue to monitor urethral healing, assess medical therapy for calculi dissolution, and to determine when the animal should be encouraged to urinate through the urethra.

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Description

This quiz explores various surgical techniques for bladder stone removal, including cystotomy, laparocystotomy, and laparoscopic approaches. Learn about the procedures, recommended methods, and post-operative considerations in equine care. Ideal for veterinary students and professionals.