RIGHT FLANK

ABOMASOPEXY

By: Occeña, Pitonang, Morales, Tul

INDICATIONS:

TREATMENT OF RIGHT-
SIDED DISPLACEMENT
AND DILATATION OF THE
ABOMASUM OR RIGHT
SIDED TORSION OF THE
ABOMASUM
Site of
incision
…
LOCAL ANESTHESIA IS
INSTITUTED BY
PERFORMING A
PARAVERTEBRAL BLOCK,
INVERTED L BLOCK, OR A
LINE BLOCK
LINE BLOCK…
ADDITIONAL INSTRUMENTATION

STERILE, MEDIUM SIZED

STOMACH TUBE, 12
GAUGE NEEDLE AND
STERILE TUBING, AND A
LARGE, STRAIGHT,
CUTTING, NEEDLE OR S-
SHAPED CURVED CUTTING
A 20-25cm INCISION IS MAD
THE COLOR OF THE ABOMASAL SEROSA
IS ASCERTAINED BEFORE ONE
ATTEMPTS TO DEFLATE THE
ABOMASUM OR CORRECT ITS POSITION
A 12-GAUGE NEEDLE WITH RUBBER
TUBING ATTACHED IS INSERTED TO
RELIEVE THE GASEOUS PRESSURE AND TO
FACILITATE FURTHER EXPLORATION AND
MANIPULATION THE NEEDLE IS PLACED IN
THE DORSAL PORTION OF THE
ABOMASUM AND IS INSERTED AT AN
IT IS EASIER TO REMOVE GAS AND
FLUID BEFORE DETORSION
BECAUSE THE ABOMASUM IS
CLOSER TO THE INCISION
A 8- TO 12-CM SIMPLE
CONTINOUS OR
INTERLOCKING SUTURE LINE
OF HEAVY POLYMERIZED
CAPROLACTAM IS PLACED IN
THE GREATER CURVATURE OF
THE ABOMASUM 5 TO 7CM
FROM THE ATTACHMENT OF
THE GREATER OMENTUM (Fig.
1).
Fig. 1
THE SUTURE BITES PASS
THROUGH THE
SUBMUCOSA, AND A METER
OF SUTURE MATERIAL
SHOULD EXTEND FROM
EACH END OF THE SUTURE
LINE. HEMOSTATS ARE
PLACED ON THESE SUTURE
ENDS IN SUCH A FASHION
THAT THE CRANIAL AND
IT IS IMPORTANT THAT THE
ABOMASUM NOT BE
DEFLATED PRIOR TO THE
INSERTION OF THE
SUTURE; OTHERWISE, THE
SITE FOR SUTURE
PLACEMENT MAY BE
RETRACTED AWAY FROM
THE INCISION
THE CRANIAL END OF THE
POLYMERIZED CAPROLACTAM IS
ATTACHED TO A LARGE, STRAIGHT,
CUTTING NEEDLE OR TO AN S-
CURVED CUTTING NEEDLE; THIS
NEEDLE IS CARRIED ALONG THE
INTERNAL BODY WALL TO A
POSITION RIGHT OF MIDLINE, BUT
MEDIAL TO THE SUBCUTANEOUS
VEIN AND 15CM CAUDAL TO THE
XIPHOID PROCESS. THE FOREFINGER
PROTECTS THE END OF THE NEEDLE,
AND THE LATERAL FINGERS REFLECT
THE VISCERA AWAY FROM THE BODY
AN ASSISTANT CAN APPLY
UPWARD PRESSURE ON THE
ABDOMINAL WALL IN THE
AREA WHERE THE NEEDLES
ARE TO BE INSERTED
THROUGH THE BODY WALL.
AN EMPTY SYRINGE CASE
WORKS WELL FOR THIS
PURPOSE.THE NEEDLE IS
INSERTED THROUGH THE
VENTRAL BODY WALL (Fig 2).
Fig 2 (applicable also to RDA)
THE ASSISTANT GRASPS THE
NEEDLE , AND THE CAUDAL SUTURE IS
PLACED THROUGH THE BODY WALL 8
TO 12CM CAUDAL TO THE CRANIAL
SUTURE. THE ASSISTANT THEN
GRASPS THE TWO SUTURE ENDS AND
APPLIES GENTLE TRACTION; AT THE
SAME TIME, THE SURGEON PUSHED
THE DEFLATED ABOMASUM INTO ITS
NORMAL POSITION. WHEN THE
SUTURED AREA OF THE ABOMASUM IS
LYING AGAINST THE FLOOR OF THE
ABDOMEN, THE ASSISTANT TIES THE
SUTURE ENDS TOGETHER (Fig 3). THE
Fig 3
Incision is sutured routinely
ANIMALS WITH RDA NEED INTENSE
FLUID THERAPY WITH PARTICULAR
EMPHASIS ON REPLACEMENT OF
THE CHLORIDE DEFICIT

FOR THIS PURPOSE, 0.9% SODIUM

CHLORIDE SOLUTION IS GENERALLY
APPROPRIATE
SUPPLEMENTATION WITH
POTASSIUM CHLORIDE MAY ALSO
BE INDICATED. WITH ADEQUATE
FLUID AND ELECTROLYTE
THERAPY
ANTIBIOTICS
ARE
ADMINISTERED
POSTOPERATIVE
The End…
(^_^)