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Turner and McIlwraith’s Techniques in Large Animal Surgery 4th Edition Turner and McIlwraith’s Techniques in Large Animal Surgery 4th Edition Dean A. Hendrickson DVM, MS, DACVS Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins, Colorado A. N. (Nickie) Bai...

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Turner and McIlwraith’s Techniques in Large Animal Surgery 4th Edition

Turner and McIlwraith’s Techniques in Large Animal Surgery 4th Edition Dean A. Hendrickson DVM, MS, DACVS Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins, Colorado A. N. (Nickie) Baird DVM, MS, DACVS Purdue University College of Veterinary Medicine West Lafayette, Indiana

This edition irst published 2013 © 2013 by John Wiley & Sons, Inc. First and Second editions, © Lea & Febiger Third edition, © Blackwell Publishing Ltd. Editorial ofices: 2121 State Avenue, Ames, Iowa 50014-8300, USA The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 9600 Garsington Road, Oxford, OX4 2DQ, UK For details of our global editorial ofices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/ wiley-blackwell. Authorization to photocopy items for internal or personal use, or the internal or personal use of speciic clients, is granted by Blackwell Publishing, provided that the base fee is paid directly to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payments has been arranged. The fee codes for users of the Transactional Reporting Service are ISBN-13: 978-1-1182-7323-4/2013. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. The contents of this work are intended to further general scientiic research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a speciic method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and speciically disclaim all warranties, including without limitation any implied warranties of itness for a particular purpose. In view of ongoing research, equipment modiications, changes in governmental regulations, and the constant low of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Hendrickson, Dean A. Turner and McIlwraith’s techniques in large animal surgery. – 4th ed. / Dean A. Hendrickson, A.N. (Nickie) Baird. p. ; cm. Techniques in large animal surgery Rev. ed. of: Techniques in large animal surgery / Dean A. Hendrickson. 3rd ed. c2007. Includes bibliographical references and index. ISBN 978-1-118-27323-4 (hardback : alk. paper) – ISBN 978-1-118-68399-6 (PDF) – ISBN 978-1-118-68404-7 – ISBN 978-1-118-68405-4 (Mobi) – ISBN 978-1-118-68429-0 – ISBN 978-1-118-68439-9 I. Baird, A.N. (Aubrey Nickie) II. Hendrickson, Dean A. Techniques in large animal surgery. III. Turner, A. Simon (Anthony Simon) Techniques in large animal surgery. IV. Title. V. Title: Techniques in large animal surgery. [DNLM: 1. Surgery, Veterinary–methods. 2. Goats–surgery. 3. Horses–surgery. 4. Surgical Procedures, Operative–veterinary. 5. Swine–surgery. SF 911] 636.089’7–dc23 2013007056 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover design by Modern Alchemy LLC Set in 10.5/12 pt Minion-Regular by Toppan Best-set Premedia Limited 1 2013

CONTENTS

Contributors

ix

Preface to the First Edition

xi

Preface to the Second Edition

xiii

Preface to the Third Edition

xv

Preface to the Fourth Edition

xvii

1. Presurgical Considerations

3

Dean A. Hendrickson, DVM, MS, DACVS

Preoperative Evaluation of the Patient Surgical Judgment Principles of Asepsis and Antisepsis Surgical Classiications Role of Antibiotics Preoperative Planning Preparation of the Surgical Site Postoperative Infection References

3 4 4 4 5 5 5 6 6

2. Anesthesia and Fluid Therapy

7

Khursheed Mama, DVM, DACVA

Anesthesia Fluid Therapy References 3. Surgical Instruments

7 23 29 33

Dean A. Hendrickson, DVM, MS, DACVS

Use of Surgical Instruments Preparation of Instruments General Surgical Instruments Instruments Used Speciically in Large Animal Surgery 4. Suture Materials and Needles

33 38 39 52 61

Dean A. Hendrickson, DVM, MS, DACVS

Suture Materials Needles References 5. Knots and Ligatures

61 67 69 71

Dean A. Hendrickson, DVM, MS, DACVS

Principles of Knot Tying Ligatures References 6. Suture Patterns

71 73 76 77

Dean A. Hendrickson, DVM, MS, DACVS

Basic Suture Patterns Suture Patterns Used for Closure of Hollow Organs

77 83 v

vi

Contents

Stent Bandages (Tie-Over Dressings) Suture Patterns for Severed Tendons References 7. Principles of Wound Management and the Use of Drains

88 88 91 93

Dean A. Hendrickson, DVM, MS, DACVS

Wound Management Methods of Closure and Healing Use of Drains References 8. Reconstructive Surgery of Wounds

93 96 97 101 103

Dean A. Hendrickson, DVM, MS, DACVS

References 9. Equine Orthopedic Surgery

111 113

Dean A. Hendrickson, DVM, MS, DACVS

Medial Patellar Desmotomy Lateral Digital Extensor Tenotomy Inferior (Distal) Check Ligament Desmotomy Superior Check Ligament Desmotomy (After Bramlage) Supericial Digital Flexor Tenotomy Deep Digital Flexor Tenotomy Sectioning of the Palmar (or Plantar) Annular Ligament of the Fetlock Palmar Digital Neurectomy Amputation of the Splint (II and IV Metacarpal and Metatarsal) Bones Arthrotomy of the Fetlock Joint and Removal of an Apical Sesamoid Chip Fracture References 10. Equine Urogenital Surgery

113 114 119 122 124 126 127 129 131 134 136 139

Dean A. Hendrickson, DVM, MS, DACVS

Castration Cryptorchidectomy by the Inguinal, Parainguinal, and Flank Approach Laparoscopic Cryptorchidectomy Caslick’s Operation for Pneumovagina in the Mare Urethroplasty by Caudal Relocation of the Transverse Fold Cesarean Section in the Mare Circumcision of the Penis (Reeing) Amputation of the Penis Aanes’ Method of Repair of Third-Degree Perineal Laceration References 11. Surgery of the Equine Upper Respiratory Tract

139 152 155 156 159 160 164 166 169 174 177

Dean A. Hendrickson, DVM, MS, DACVS

Tracheostomy Laryngotomy, Laryngeal Ventriculectomy, and Ventriculocordectomy Partial Resection of the Soft Palate Surgical Entry and Drainage of the Guttural Pouches References 12. Equine Dental and Gastrointestinal Surgery

177 179 183 186 189 191

Dean A. Hendrickson, DVM, MS, DACVS

Repulsion of Cheek Teeth Ventral Midline Laparotomy and Abdominal Exploration Standing Flank Laparotomy Umbilical Herniorrhaphy in the Foal References 13. Bovine Gastrointestinal Surgery

191 196 202 207 210 211

A. N. Baird, DVM, MS, DACVS

Principles of Laparotomy Flank Laparotomy and Abdominal Exploration Rumenotomy Rumenostomy (Rumenal Fistulation)

211 212 215 219

Contents

Surgical Corrections of Abomasal Displacements and Torsion Surgical Correction of Cecal Dilatation/Volvulus Small Intestinal Resection and Anastomosis References 14. Bovine Urogenital Surgery

vii

221 231 231 232 235

A. N. Baird, DVM, MS, DACVS

Calf Castration Urethrostomy Hematoma Evacuation of the Bovine Penis Preputial Resection and Anastomosis in the Bull Surgical Techniques for Teaser Bull Preparation Inguinal Herniorrhaphy in the Mature Bull Unilateral Castration Cesarean Section in the Cow Retention Suturing of the Bovine Vulva (Buhner’s Method) Cervicopexy for Vaginal Prolapse (after Winkler) References 15. Bovine General Surgery

235 236 241 245 248 252 257 258 265 266 270 273

A. N. Baird, DVM, MS, DACVS

Digit Amputation Digit Amputation via Disarticulation Eye Enucleation Cosmetic Dehorning Rib Resection and Pericardiotomy Repair of Teat Lacerations Third Eyelid Resection Tracheotomy Umbilical Surgery References 16. Small Ruminant Surgery

273 274 276 277 280 283 288 288 289 290 293

A. N. Baird, DVM, MS, DACVS

Dehorning the Mature Goat Disbudding the Young Goat Obstructive Urolithiasis Mastectomy Vasectomy Cesarean Section Rectal Prolapse Resection in Small Ruminants References 17. Camelid Surgery

293 295 296 297 298 299 300 301 303

A. N. Baird, DVM, MS, DACVS

Castration of the Llama Cesarean Section in the Camelid Tooth Removal in the Llama References 18. Swine Surgery

303 304 305 309 311

A. N. Baird, DVM, MS, DACVS

Castration of the Piglet Inguinal Herniorrhaphy in the Piglet Cryptorchid Castration of Piglets Preputial Diverticulum Ablation Cesarean Section in the Sow Ovariohysterectomy in the Pot-Bellied Pig Rectal Prolapse Ring Placement References Index

311 312 314 316 317 319 319 320 323

CONTRIBUTORS

Dean A. Hendrickson, DVM, MS, DACVS Editor-in Chief Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins, Colorado

Khursheed Mama, DVM, DACVA Colorado State University College of Veterinary Medicine and Biomedical Sciences Fort Collins, Colorado

A. N. (Nickie) Baird, DVM, MS, DACVS Associate Editor Purdue University College of Veterinary Medicine West Lafayette, Indiana

ix

PREFACE TO THE FIRST EDITION

The purpose of this book is to present some fundamen­ tal techniques in large animal surgery to both veterinary students and large animal practitioners. It is designed to be brief, discussing only the major steps in a partic­ ular operation, and each discussion is accompanied by appropriate illustrations. Most of the techniques pre­ sented in this book can be performed without the advan­ tages of a fully equipped large animal hospital or teaching institution. The book assumes a basic understanding of anatomy and physiology. Those who wish to know more about a particular technique are encouraged to consult the bibliography. We and our colleagues at the Colorado State University Veterinary Teaching Hospital consider the procedures dis­ cussed in this book to be time honored. Some practitio­ ners may perform certain techniques in slightly different ways. We would be happy to receive input about modii­ cations of these techniques for future editions of this book. All of the drawings in the book are original and based on rough sketches and photographs taken at various points during actual surgery. Occasionally, dissections were performed on cadavers. The surgical procedures described in this text represent not only our thoughts, but suggestions from many of our colleagues as well. Their help was an important contribu­ tion to the production of this book. We are indebted to Dr. Wilbur Aanes, Professor of Surgery, Colorado State University, who unselishly shared 30 years of his personal experience in large animal surgery with us. We are proud to be able to present in Chapter 10 of this book “Aanes’ Method of Repair of Third­Degree Perineal Laceration” in the mare, a technique that he pioneered over 15 years ago. We also wish to give credit to the following faculty members at Colorado State University Veterinary Teach­ ing Hospital who willingly gave us advice on the diagrams and manuscript of various techniques discussed in this book: Dr. Leslie Ball, Dr. Bill Bennett, Dr. Bruce Heath, Dr. Tony Knight, Dr. LaRue Johnson, Dr. Gary Rupp, Dr. Ted Stashak, Dr. Gayle Trotter, Dr. James Voss, and Dr.

Mollie Wright. We also wish to express appreciation to Dr. John Baker, Purdue University, and Dr. Charles Wallace, University of Georgia, for their comments on some ques­ tions we had. Dr. McIlwraith is also grateful to Dr. John Fessler, Professor of Surgery, Purdue University, for his inspiration and training. We are particularly grateful to Dr. Robert Kainer, Pro­ fessor of Anatomy, Colorado State University, for check­ ing the manuscript and the illustrations and advising us on nomenclature. His input impressed upon us the importance of the relationship between the dissection room and the surgery room. The terriic amount of time and effort involved with the illustrations will be clear to the reader who cares only to leaf through the book. For these illustrations, we are indebted to Mr. Tom McCracken, Director, Ofice of Bio­ medical Media, Colorado State University. We are thank­ ful for his expertise, as well as his cooperation and understanding. The diagrams for “Aanes’ Method of Repair of Third­Degree Perineal Laceration” were done by Mr. John Daughtery, Medical Illustrator, Colorado State University. We must also thank Kathleen Jee, who assisted with various aspects of the artwork. We would also like to thank Messrs. Al Kilminster and Charles Kerlee for taking photographs during the various surgical pro­ cedures that were used to assist with the artwork of this text. The manuscript was typed by Mrs. Helen Mawhiney, Ms. Teresa Repphun, and Mrs. Jan Schmidt. We thank them for their patience and understanding during the many changes we made during the generation of the inal manuscript. We are grateful to the following instrument companies for allowing us to use some of the diagrams from their sales catalogs for inclusion in Chapter 3, “Surgical Instru­ ments”: Schroer Manufacturing Co., Kansas City, MO; Intermountain Veterinary Supply, Denver, CO; Miltex Instrument Co., Lake Success, NY; J. Skyler Manufactur­ ing Co., Inc., Long Island, NY. The idea for this book was conceived in 1978 when one of us (AST) was approached by Mr. George Mundroff, xi

xii

Preface to the First Edition

Executive Editor, Lea & Febiger. We would like to thank him for his encouragement and guidance. We are also grateful to Mr. Kit Spahr, Jr., Veterinary Editor; Diane Ramanauskas, Copy Editor; Tom Colaiezzi, Production Manager; and Samuel A. Rondinelli, Assistant Production Manager, Lea & Febiger, for their assistance, as well as to

others at the Publisher who assisted in the production of this book. A. Simon Turner C. Wayne McIlwraith Fort Collins, Colorado

PREFACE TO THE SECOND EDITION

The second edition of Techniques in Large Animal Surgery is in response to the acceptance of the irst edition and the continued need for such a book for both veterinary students and large animal practitioners. In many instances, the techniques are time honored and require no change from 5 years ago. In other instances, however, reinements in technique as well as improved perception of indications, limitations, and complications have made changes appropriate. A signiicant change is the addition of Dr. R. Bruce Hull, Professor of Veterinary Clinical Sciences, The Ohio State University, as a contributor. He has carefully analyzed the entire bovine section, and his suggested changes and additions have been incorporated into the text. In addition, two procedures, “teaser bull preparations by penile ixation” and “treatment of vaginal prolapse by ixation to the prepubic tendon,” have been added. We are most grateful in having Dr. Hull’s help and expertise. Among the introductory chapters, the section on anesthesia required the most updating, and we are grateful to our colleague Dr. David Hodgson at Colorado State University for his review and advice. Two new procedures, “superior check ligament desmotomy” and “deep digital lexor tenotomy,” were considered appropriate additions to this edition. We are grateful to Dr. Larry Bramlage, Ohio State University, for his comments and help with the irst of these procedures. Many of the other changes in this edition are in response to the book reviews and comments on the irst edition returned to Lea & Febiger. To these people, we appreciate your feedback.

A chapter on llama tooth removal was added because of the increased popularity of this species, especially in our own part of the country. Although we only discuss this one technique, it should not be inferred that other operations are unheard of in llamas. We have corrected angular limb deformities, repaired fractures, and performed gastrointestinal surgery, among other procedures, but tooth removal is the most common. Descriptions of these other procedures in llamas are beyond the scope of this book at this stage. The need for more sophisticated equine techniques prompted us to produce the textbook Equine Surgery: Advanced Techniques in 1987. It is envisioned that the book will be used as a companion to this second edition, to provide a full spectrum of equine procedures, with the well-accepted format of concise text and clear illustrations. Again, we are thankful to Mr. Tom McCracken, Assistant Professor, Department of Anatomy and Neurobiology, Colorado State University, for his talent in capturing the techniques described in his line drawings. We are also indebted to Helen Acvedo for typing our additions and to Holly Lukens for copyediting. Finally, our thanks again to the excellent staff at Lea & Febiger for the production of this edition. A. Simon Turner C. Wayne McIlwraith Fort Collins, Colorado

xiii

PREFACE TO THE THIRD EDITION

The irst two editions of Techniques in Large Animal Surgery have been well accepted, much to the credit of Drs. Turner and McIlwraith. They have been excellent texts for the veterinary student and the large animal practitioner. I was fortunate to be able to take on the task when it came time to update the information for a third edition. I am deeply appreciative of the opportunity to take such an excellent text and update it with new information and techniques. The third edition of Techniques in Large Animal Surgery has been updated in response to the continued need for such a book for both veterinary students and large animal practitioners. There are some techniques that are time tested and continue to be included. There are other tec...