Surgery of Exotic Animals
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Группа авторов. Surgery of Exotic Animals
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Surgery of Exotic Animals
List of Contributors
Preface
About the Editors
1 General Principles, Instruments, and Equipment
Introduction
Presurgical Considerations
Patient Support
Data Base
Preoperative Fasting
Hemodynamic Support
Perioperative Antibiotic Therapy
Surgeon Aseptic Preparation
Patient Preparation
Patient Draping
Thermal Support
Instrumentation and Equipment. Hemostatic Aids
Electronic Hemostatic Devices. Electrocautery
Electrosurgery
Vessel Sealing Devices
Harmonic Scalpel
Carbon Dioxide Laser
Magnification
Focal Light
Retractors
Instrumentation
Suction and Irrigation
References
2 Suture Materials
Introduction
Suture Materials
Absorbable Suture Materials
Biologic Absorbable Suture Material. Chromic Gut
Synthetic Absorbable Suture Materials
Polydioxanone
Poliglecaprone 25
Polyglactin 910
Polyglyconate
Glycomer™ 631
Polyglycolic Acid
Polyglytone 6211
Lactomer™
Nonabsorbable Suture Materials
Biologic Nonabsorbable Suture Materials. Silk
Nylon
Polypropylene
Stainless Steel
Barbed and Antibacterial‐Coated Suture
Tissue Healing
Sutures in Exotic Animals. Rodents
Rabbits
Ferrets
Birds
Reptiles and Amphibians
Fish
Invertebrates
Conclusion
Acknowledgments
References
3 Magnification Surgery
Introduction
Optics and Principles of Magnification
The Operating Microscope
Preoperative Preparation of the Microscope and Operating Room
Surgical Loupes
Choosing Surgical Loupes
Comparing the Operating Microscope and Surgical Loupes
Illumination
Instrumentation
Microsurgical Instrumentation
Care and Handling of Instruments
Microsuture
Principles of Microsurgical Techniques
Posture
Preparation and Mindset
Hand Position
References
4 Invertebrate Surgery
Introduction
Porifera (Sponges)
Coelenterates
Gastropod Mollusks
Cephalopod Mollusks
Annelids
Crustaceans
Arachnids
Limulus
Insects
Echinoderms
Urochordates
References
5 Fish Surgery
Perioperative and Postoperative Surgical Management. Water
Analgesia, Anesthesia, and Fluids
Antibiotics
Surgical Table
Surgical Modalities
Wounds
Skin Surgery
Orthopedic Surgery
Ophthalmic Surgery
Cataract Surgery
Enucleation
Coelomic Surgery
Swim Bladder Surgery
Reproductive Surgery
Urinary Surgery
Digestive Tract Surgery
Minimally Invasive Surgery
Telemetry and Microchip Implantation
References
6 Amphibian Surgery
Introduction
Perioperative and Postoperative Considerations
Wound Healing
Skin Surgery
Orthopedic Surgery
Ophthalmic Surgery
Coelomic Surgery
Urogenital Surgery
Gastrointestinal Tract Surgery
Minimally Invasive Surgery
Telemetry and Microchip Implantation
References
7 Reptile Orthopedic Surgery
Introduction
Anatomy and Physiology
Diagnostics
Trauma
Bone Composition, Bone Healing, and Fracture Repair
Bone Healing
Principles of Fracture Stabilization
External Coaptation
Internal Fixation
External Skeletal Fixation
Shell Fractures
Joint Disease
Proliferative Spinal Osteopathy
References
8 Surgical Approaches to the Reptile Coelom
Chelonian Coelom. Prefemoral Approach
Scope‐assisted Celiotomy in Large Chelonians
Plastron Osteotomy
Partial Plastron Ostectomy
Lateral Plastron Osteotomy Combined with Prefemoral Approach
Snake Coelom. Lateral Approach
Lizard and Crocodilian Coelom. Ventral Paramedian Approach
Paracostal Approach
Postfemoral Approach for Renal Biopsy in Iguanids
References
9 Reptiles: Soft Tissue Surgery
Anatomy
Surgery of the Female Reproductive Tract
Ovariectomy
Salpingotomy
Ovariosalpingectomy
Orchidectomy
Reproductive Organ Prolapse
Non Reproductive Cloacal Organ Prolapses
Cystotomy
Gastrointestinal Procedures
Gastrotomy
Enterotomy
Intestinal Resection and Anastomosis
References
10 Avian Orthopedics
Biology of Bone Healing
Patient Evaluation
Fracture Management Options. Cage Confinement
Coaptation
Bandages and Splints. Body Wrap
Figure‐of‐Eight Bandage
Modified Robert Jones
Lateral Splint
Spica Splint (Femoral Fractures)
Curved Edge/Metacarpal Splint
Tape Leg Splint
Schroeder–Thomas Splint
Surgical Stabilization
Internal Fixation
Intramedullary (IM) Pin
Orthopedic Wire
Bone Plates
Nonlocking Plate Application
Locking Plate Application
Interlocking Nails (ILNs)
External Skeletal Fixation (ESF)
Linear ESF
Biphasic ESF
IM‐ESF Tie‐In
Ring Fixators and Hybrid Fixators
Bone Grafting
Fracture Conclusions
Luxation Management Options
Luxation of the Shoulder
Luxation of the Elbow
Luxation of the Carpus
Luxation of the Hip
Luxation of the Stifle
Luxation of the Tarsus
Luxation of the Metacarpophalangeal Joint
Arthrodesis
Luxation Conclusion
Angular Limb Deformities (ALD)
Perosis (Achilles Tendon Luxation)
Postoperative Care
Monitoring for Healing and Complications
Beak Repair
Scissor Beak
Mandibular Prognathism
Beak Fractures
References
11 Approaches to the Caudal Coelom (Abdomen) of Birds
Anatomy
Patient Preparation
Skin Incision
Left Lateral Celiotomy
Right Lateral Celiotomy
Ventral Celiotomy
Transverse Celiotomy
References
12 Avian Reproductive Procedures
The Male Reproductive Tract
Orchidectomy
Vasectomy
The Female Reproductive Tract
Surgery of the Ovary
Surgery of the Oviduct and Uterus (Shell Gland)
Salpingohysterectomy
Salpingohysterotomy
References
13 Surgery of the Avian Gastrointestinal Tract
Anatomy and Physiology
Surgery of the Mouth
Surgery of the Esophagus
Surgery of the Stomach
Proventriculotomy and Ventriculotomy
Proventriculotomy or Ventriculotomy Through the Isthmus
Gastrotomy in Carnivores and Piscivores
Gastrotomy in Ratites
Ventriculotomy
Surgery of the Intestines
Surgery of the Cloaca. Cloacotomy
Cloacopexy
Ventplasty
Duodenostomy Feeding Tube
Liver Biopsy
Pancreatic Biopsy
Postoperative Management
References
14 Surgery of the Avian Respiratory System and Cranial Coelom
Surgery of the Upper Respiratory Tract. Choanal Atresia Correction
Sinusotomy
Approach to the Rostral Diverticulum and Maxillary Chamber
Approach to the Preorbital Diverticulum
Approach to the Infraorbital Diverticulum
Approach to the Suborbital, Postorbital, Preauditory, or Mandibular Diverticulum
Surgery of the Lower Respiratory Tract. Air Sac Cannula Placement
Tracheotomy
Tracheal Resection and Anastomosis
Lateral Approach to the Syrinx
Devocalization
Lung Biopsy and Partial Pneumonectomy
Hyperinflation of the Cervicocephalic Air Sac
Surgery of the Cranial Coelom. Cranial Celiotomy
Bifid Sternum Surgical Management
References
15 Minimally Invasive Surgery Techniques in Exotic Animals
Introduction
Instrumentation
Patient Positioning
Laparoscopy. Patient Preparation
Complications
Coelioscopy in Birds and Reptiles. Avian Coelioscopy
Reptile Coelioscopy
Specific Laparoscopic Techniques. Liver Biopsy
Pancreatic Biopsy
Renal Biopsy
Intestinal Biopsy
Other Diagnostic Techniques
Feeding Tube Placement
Ovariectomy/Ovariohysterectomy
Avian Salpingohysterectomy
Endoscopic Avian Vasectomy
Chelonian Oophorectomy/Ovariectomy/Ovariosalpingectomy
Cryptorchid and Abdominal Castration
Endoscopic Avian Orchidectomy
Endoscopic Green Iguana Orchidectomy
Endoscopic‐Assisted Chelonian Orchidectomy
Cystotomy
Thoracoscopy
Thoracoscopic Procedures. Thoracoscopic Lung Lobectomy, Partial Lobectomy, and Lung Biopsy
Hilar Lymph Node and Mediastinal Mass Biopsy and Removal
Nephrectomy in a Rabbit
Summary
References
16 Orthopedic Surgery in Small Mammals
Anatomy and Physiology
Diagnostics
Joint Disease
Trauma
Bone Composition and Bone Healing. Bone Composition
Bone Healing
Principles of Fracture Stabilization
Fractures
Repair of Specific Fractures
Fractures of the Humerus
Fractures of the Radius and Ulna
Fractures of the Metacarpal Bones
Fractures of the Pelvic Bones
Fractures of the Femur
Fractures of the Tibia and Fibula
References
17 Rabbit Soft Tissue Surgery
Introduction
Celiotomy
GI Surgery
Anatomy
Gastric Surgery
Intestinal Obstruction
Gastrostomy
Surgical Management of Intestinal Obstruction
Liver Lobe Torsion
Urinary Tract Surgery
Anatomy
Urolithiasis
Nephrolithiasis. Nephrectomy
Nephrotomy
Pyelotomy
Ureterolithiasis. Tube Nephrostomy
Ureterotomy
Ureteral Stenting
Subcutaneous Ureteral Bypass (SUB) Device
Ureteroneocystostomy
Cystolithiasis. Cystotomy
Transvesicular Percutaneous Cystolithotomy (TPC)
Urethrolithiasis. Tube Cystostomy
Urethrotomy
Renal Biopsy
Nephrectomy
Partial Cystectomy
Transurethral Urinary Bladder Eversion and Prolapse
Inguinal Urinary Bladder Herniation
Postoperative Considerations
Reproductive Tract Surgery
Anatomy of the Female Reproductive Tract
Ovariectomy
Ovariohysterectomy
Anatomy of the Male Reproductive Tract
Open Orchiectomy
Closed Orchiectomy
Abdominal Orchiectomy
Thoracic Surgery
Thymoma and Thymic Lymphoma
Lung Lobe Abscesses
Ventral Thoracotomy
Lateral Thoracotomy
Postoperative Care
Enucleation and Exenteration
Ear Surgery. Anatomy
History and Clinical Signs
Diagnostic Evaluation
Medical Management
Auricular Surgery. Partial Pinnectomy
Auricular Hematomas
Ventral Bulla Osteotomy (VBO)
Ear Canal Ablation and Lateral Bulla Osteotomy
Abscess Management
Postoperative Care
References
18 Ferret Soft Tissue Surgery
Surgical Abdominal Anatomy
Hepatobiliary System
Gastrointestinal Tract
Pancreas
Spleen
Adrenal Glands
Urogenital System
Celiotomy and Closure
Surgical Procedures. Adrenalectomy
Partial Pancreatectomy
Splenectomy
Gastrointestinal Surgery
Gastrointestinal Foreign Body Removal
Pyloric Outflow Obstruction
Oral Cavity Disease
Abdominal Organ Biopsy
Urogenital Surgery
Urolithiasis
Preputial Masses
Miscellaneous Procedures. Tail Amputation
Anal Sacculectomy
Cardiac Pacemaker
Vascular Access Port
References
19 Rodent Soft Tissue Surgery
Introduction
Reproductive Tract Surgery. Orchidectomy
Anatomy
Percutaneous Orchidectomy
Hystrichomorph Rodents
Non‐Hystrichomorph Rodents
Abdominal Approach for Orchidectomy
Paraphimosis
Ovariectomy and Ovariohysterectomy
Cystic Ovaries
Ovarian Tumors
Pyometra
Anatomy
Ovariectomy
Ovariohysterectomy
Cesarean Section
Uterine Prolapse
Cutaneous and Subcutaneous Masses. Mammary Tumors
Anatomy
Mastectomy
Other Cutaneous and Subcutaneous Masses
Cervical Lymphadenitis in Guinea Pigs
Other Subcutaneous Abscesses
Gastrointestinal Surgery. Gastric Trichobezoars
Cheek Pouch Eversion
Other Gastrointestinal Surgery
Urinary Tract Surgery
Urolithiasis
Ureterotomy
Cystotomy
Urethrotomy
Intraabdominal Masses
Thoracic Surgery
Lateral Intercostal Thoracotomy
Ventral Midline Thoracotomy
Enucleation and Exenteration
Ear Surgery
Tail Degloving
Pododermatitis
Recovery
References
20 Soft Tissue Surgery in Hedgehogs
Ovariohysterectomy and Mammary Tumor Removal
Orchiectomy
Posthitis and Paraphimosis
Neoplastic Disease in Hedgehogs
Proptosis and Enucleation
Leg and Foot Injuries
Intervertebral Disc Disease
References
21 Surgery of the Sugar Glider
Introduction
Orchiectomy
Penectomy
Abdominal Surgical Approach
Ovariectomy and Ovariohysterectomy
Patagial Surgery
Tail Amputation
Removal of the Paracloacal Glands
References
22 Small Mammal Dental Surgery
Incisor Extraction. Intraoral Approach
Extraoral Approach (Osteotomy)
Elodontoma Treatment
Cheek Tooth Extraction. Intraoral Approach
Extraoral Approach (Apical Osteotomy)
Mandibular Osteotomy (P3‐M3 in Rabbits)
Maxillary Osteotomy (P2‐P3 in Rabbits)
Maxillary Osteotomy (P4‐M1 in Guinea Pigs)
Surgery of Mandibular Abscesses
Apicoectomy
Alternative Methods of Abscess‐Treatment
Surgery of Rostral Maxillary Abscesses. Extraoral Tooth Extraction (P2, P3) and Sinusotomy in Rabbits
Lateral Fenestration of the Nasolacrimal Duct
Dorsal Rhinostomy
Surgery of Retrobulbar Abscesses. Extraoral Tooth Extraction Combined with Orbital Exenteration or Partial Resection of the Zygomatic Arch in Rabbits
Treatment of Jaw Fractures
Stabilization of a Mandibular Symphysiolysis
Condylectomy
Alveolectomy and Mandibulectomy. Segmental, Partial, or Complete
References
23 Large Mammal Dental Surgery
Introduction
Preprocedure Considerations
Terminology
Box 23.1 American Veterinary Dental College classification of tooth injury
Elephants
Tusks
Partial Pulpectomy
Tusk Extraction
Molars. Odontoplasty
Molar Extraction
Extraction Site Maintenance
Chronic Alveolar Osteitis and Osteomyelitis
Surgical Fistulation
References
24 Primate Surgery
Personal Protective Equipment and Zoonotic Concerns During Surgery
Integument and Appendages
Respiratory Tract
Orthopedics
Abdominal Surgery
Hernias
Retroperitoneal and Abdominal Abscesses
Intestinal Acanthocephala Infestation (Thorny‐Headed Worms)
Trichobezoar and Phytobezoar
Cholecystectomy
Choledochotomy, Choledochal Tube Stenting, and Cholecystoenterostomy
Gastrointestinal Neoplasms
Reproductive Surgery
Acknowledgment
References
25 Marine Mammal Surgery
Background
Surgery of Pinnipeds. Ocular Surgery
Phacoemulsification
Extracapsular Lens Extraction
Intracapsular Lens Extraction
Conjunctival Graft
Cyclosporine Implants for Keratopathy
Orthopedic Surgery
Abdominal Surgery. Castration/Ovariectomy
Telemetry Implantation
MIS Procedures
Surgery of Cetaceans. Oral Surgery
Ocular Surgery
Abdominal Surgery
Closure of Surgical Incisions
References
26 Megavertebrate Laparoscopy
Instrumentation
Elephant Laparoscopy and Minimally Invasive Surgery
Vasectomy
Functional Ovariectomy
Body Wall Closure
Rhinoceros Laparoscopy
Ovariectomy
Hippopotamus Laparoscopy
References
27 Zoo Animal Surgery
General Considerations
Partnerships
Diversity
Forces
Postoperative Management
Surgeries. Contraception. Melengestrol Acetate Implants (MGA)
Deslorelin Implants
Vasectomy
Epididymectomy in Hoof Stock
Castration in Big Cats
Castration in Large Rodents
Ovariectomy and Ovariohysterectomy in Big Cats
Miscellaneous. Onychectomy (Declaw) in Exotic Felids
Defanging Primates and Carnivores
Tail Removal in Primates
References
28 Surgical Oncology in Exotics
Principles of Surgical Oncology and Application to Exotics
Birds
Integumentary and Musculoskeletal Tumors
Lipomas/Liposarcomas
Soft Tissue Sarcomas
Bone Tumors
Hemangioma/Hemangiosarcoma
Alimentary Tumors
Adjuvant Therapies. Radiation Therapy
Chemotherapy
Rabbits
Tumors of the Reproductive Tract
Urinary Tract Tumors
Thymic Neoplasia
Tumors of the Skin
Tumors of Bone
Ferrets
Endocrine. Adrenal Tumors
Pancreatic Tumors
Integumentary
Reproductive
Rodents
Tumors in Rats and Mice. Skin and SQ
Reproductive/Mammary Tumors
Endocrine
Hamsters
Chinchillas
Guinea Pigs. Skin and SQ
Reproductive/Mammary
Endocrine
Respiratory
Reptiles
Hepatic Tumors
Cutaneous Tumors
Endocrine Tumors
Musculoskeletal Tumors
Urogenital Tumors
Gastrointestinal Tumors
Treatment Options. Surgery
Radiation Therapy
Chemotherapy/Electrochemotherapy
Cryosurgery and Photodynamic Therapy
References
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The bipolar electrosurgical forceps are primarily used for hemostasis, but can also be used for tissue dissection resulting in minimal hemorrhage. The same generator is used, but the patient is not within the electrical circuit so the current only affects tissue within the tips of the forceps. Bipolar forceps are most useful near structures that would be adversely affected by the current such as the heart, brain, spinal cord, etc., or for hemostasis deep within body cavities. When using bipolar to dissect or cut tissue, grasp the tissue in the forceps and activate the current while pulling the forceps. The tissue within the tips will be affected by the current providing hemostasis for small vessels within the tissue grasped. In birds, this technique is useful for making a skin incision. Grasp the skin with the forceps and activate the current to create a small defect in the skin. Then insert one limb of the forceps under the skin for 1–2 cm, oppose the other limb of the forceps, activate the current, and withdraw the forceps, thus cutting the skin. Bipolar mode is available on most electrosurgical units including the Surgitron®.
LigaSure™ (Medtronic, Minneaplis, MN) is a vessel/tissue sealing system that is commonly used in veterinary surgery. The ForceTriad™ (Medtronics, Minneapolis, MN) combines the LigaSure technology with monopolar and bipolar electrosurgery. While the specific technology is proprietary, LigaSureTM is a type of bipolar electrosurgery. The generator senses the electrical impedance of the tissues within the tips and delivers the amount of current needed to melt the elastin and collagen; it then allows the elastin and collagen to re‐form, creating a permanent seal in a single application. It generates less than 1 mm of heat lateral to the seal and is Food and Drug Administration (FDA)‐approved to seal vessels up to 7 mm diameter. A wide range of handpieces are available for open surgical procedures and for minimally invasive surgeries.
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