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The coelomic cavity may be approached ventrally or laterally. For a ventral approach, make either an incision caudal to the pelvic fins just cranial to the vent (Figure 5.16) or an incision from the pectoral to the pelvic fins. If wider access to the coelom is needed, section the pelvic girdle on midline. The pelvic bones are joined on midline by a fibrous junction in some younger fish which becomes ossified in older specimens (Harms and Wildgoose 2001). During the approach, take care to avoid damaging the digestive tract, especially if a coelomic mass is displacing the intestine near the ventral body wall (Weisse et al. 2002; Weber 2011b). Perform a lateral approach or an L‐shaped incision in the coelom to access dorsal organs such as the kidneys or the swim bladder (Harms and Wildgoose 2001). Make the craniocaudal incision just ventral to the lateral line of the fish, extending from the caudal edge of the pectoral fin to the level of the anus. Make the dorsoventral incision at the level of the anus and extend as needed for exposure; do not incise too close to the sphincter of the anus.

Coelomic adhesions are common in some species of fish including koi and are not necessarily an indication of coelomitis (Wildgoose 2000; Boone et al. 2008; Grosset et al. 2015). During the celiotomy, take care to limit traction on the coelomic wall as trauma to this delicate tissue can result in postoperative necrosis of the body wall. An assistant may gently retract the coelomic wall using a Farabeuf or Roux retractor or a self‐retaining retractor such as Heiss, Lone Star, or Gelpi retractors, or a Barraquer eyelid speculum may be used depending on the size of the fish (Harms and Wildgoose 2001).

Figure 5.16 Incision of the coelom between the pelvic fins and the digestive orifice in an anesthetized goldfish (Carassius auratus). A Lone Star retractor is placed on the coelomic cavity to facilitate visualization.

Source: Photo courtesy: Zoological Medicine Service, Université de Montréal.

Close the coelomic wall in two layers: muscle and skin (Harms and Wildgoose 2001). During closure, take care to close the pelvic girdle in accurate apposition if it has been sectioned. A subcuticular pattern rather than cutaneous suture is recommended in goldfish, as this induces less local reaction than simple interrupted sutures or interrupted horizontal mattress sutures (Nematollahi et al. 2010). Ideally, leave no additional air in the coelom during closure to avoid buoyancy problems. Also, consider the weight of suture materials and any prosthetics or surgical devices in very small patients (Britt et al. 2002).

Do not remove sutures before four weeks (Shin et al. 2011). Sutures may be removed after four to eight weeks in temperate species (Sladky and Clarke 2016). Months may be necessary for adequate healing before suture removal in cold‐water species. Carefully examine the wound margins to assess skin continuity prior to suture removal.