Gastrointestinal Surgical Techniques in Small Animals

Eric Monnet, DVM, PhD, FAHA, Diplomate ACVS, ECVS, is a Professor in the Department of Clinical Sciences at Colorado State University in Fort Collins, Colorado, USA.

Dan Smeak, DVM, Diplomate ACVS, is a Professor in the Department of Clinical Sciences at Colorado State University in Fort Collins, Colorado, USA.

List of Contributors


Preface


About the Website


Section I: General concepts


Chapter 1: Intestinal healing


Eric Monnet and Daniel Smeak


Anatomy


Phases of wound healing


Factors affecting gastrointestinal tract healing


Chapter 2: Suture materials, staplers, and tissue apposition devices


Daniel Smeak


Suture materials


Predictable absorption profile


Tensile strength and knot security


Low capillarity and bacterial adhesion


Handling characteristics


Rate of strength gain in GI surgery


Suture needles


Directional barbed suture


Biofragmentable anastomosis ring


Staplers, Linear, Circular, Skin staplers


Chapter 3: Suture pattern


Daniel Smeak


One or two layer closure


Tissue inversion eversion or apposition


Stapled or hand-sutured anastomosis


Apposition suture patterns


Simple interrupted


Simple continuous


Patterns to reduce excessive mucosal eversion


Inverting suture patterns


Halstead


Cushing and Connell


Lembert


Parker Kerr oversew


Special supplementary patterns: Purse-string


Chapter 4: Feeding tubes


Eric Monnet


Nasoesophageal and nasogastric tubes


Indications


Materials and equipment


Surgical techniques


Utilization


Tips


Complications


Esophagostomy tube


Indications


Materials and equipment


Surgical techniques


Utilization


Tips


Complications


Gastrostomy tube


Indications


Materials and equipment


Surgical techniques


Endoscopic placement


Laparoscopically assisted


Laparotomy


Utilization


Tips


Complications


Jejunostomy tube


Indications


Materials and equipment


Surgical techniques


Laparoscopically assisted


Laparotomy


Utilization


Tips


Complications


Gastro-Jejunostomy tube


Indications


Materials and equipment


Surgical techniques


Utilization


Tips


Complications


Chapter 5: Drainage technique


Eric Monnet


Indications


Techniques


Percutaneous placement of an abdominal drain


Passive drain


Closed suction drain


Surgical placement of a closed suction drain


Open abdomen


Vacuum assisted drainage of the abdominal cavity


Tips


Complications and after care


Section II: Oral cavity


Chapter 6: Mandibulectomy and maxillectomy


Bernard Seguin


Indications


Surgical techniques


Maxillectomy


Mandibulectomy


Tips


Complications and postoperative care


Complications of maxillectomy


Complications of mandibulectomy


Chapter 7: Glossectomy


Eric Monnet and Bernard Seguin


Indications


Surgical techniques


Tips


Complications and prognosis


Chapter 8: Tonsillectomy


Eric Monnet and Bernard Seguin


Indications


Surgical techniques


Tips


Complications and prognosis


Chapter 9: Palate defect


Chad Lothamer and Jennifer Rawlinson


Indications


Surgical techniques


Repair of congenital cleft palate correction techniques


Secondary cleft palate correction techniques


Von Langenbeck technique


Overlapping flap technique


Soft palate repair techniques


Bilateral medially positioned flaps


Overlapping flap technique for repair of the soft palate


Repair of acquired defects


Vestibular mucoperiosteal flaps


Palatal mucoperiosteal flaps


Transposition flap


Split palatal U-flap


Rotating palatal island flap


Palatal advancement flaps


Miscellaneous palatal repair and salvage techniques


Midline palatal fracture or separation


Myoperitoneal microvascular free flap


Angularis Oris mucosal flap


Obturators


Bone and cartilage grafts for the support of pedicle grafts


Tips


Complications


Chapter 10: Salivary glands surgery


Daniel Smeak


Indications


Surgical techniques


Anatomical considerations


Removal of sialoliths


Cervical, pharyngeal, rankle mucocele


Approaches to the mandibular/sublingual salivary complex


Ventral Approach


Marsupialization of Pharyngeal Mucoceles and Ranulas


Zygomatic salivary mucocele


Surgical exposure (approaches) for zygomatic sialadenectomy


Gland Excision Technique


Parotid mucocele


Tips


Complications and outcome


Section III: Esophagus


Chapter 11: Esophagotomy


Eric Monnet


Indications


Surgical techniques


Surgical approach to the esophagus


Esophagotomy


Patch


Tips


Complications


Chapter 12: Esophagectomy


Eric Monnet


Indications


Surgical techniques


Esophagectomy


Dilation and diverticulum of the esophagus


Substitution


Tips


Complications


Chapter 13: Cricopharyngeal myectomy and Heller myectomy


Eric Monnet


Indications


Surgical techniques


Cricopharyngeal myotomy


Heller's myotomy


Tips


Cricopharyngeal myotomy


Heller's myotomy


Complications


Chapter 14: Vascular ring anomalies


Eric Monnet


Indications


Surgical techniques


Intercostal thoracotomy


Ligamentum arteriosum


Double aortic arch


Thoracoscopy


Tips


Complications and aftercare


Chapter 15: Hiatal hernia


Eric Monnet


Indications


Surgical techniques


Laparotomy


Laparoscopy


Tips


Complications and post-operative cares


Section IV: Stomach


Chapter 16: Anatomy and physiology of the stomach


Eric Monnet


Anatomy


Divisions


Morphology and glandular organization


Blood supply


Innervation


Physiology


Gastrin


Somatostatin


Histamine


Ghrelin and leptin


Other gastric secretory products


Acid secretion


Acid secretions and gastrectomy


Stomach motility and gastrectomy


Chapter 17: Gastrotomy


Eric Monnet


Indications


Surgical techniques


Tips


Complications and post-operative cares


Chapter 18: Gastrectomy


Eric Monnet


Indications


Surgical techniques


Local gastrectomy for resection of neoplasia or ulcer


Local gastrectomy for resection of GDV


Segmental gastrectomy


Tips


Complications and post-operative cares


Chapter 19: Billroth I


Eric Monnet


Indications


Surgical techniques


Tips


Complications


Chapter 20: Billroth II


Eric Monnet


Indications


Surgical techniques


Gastrectomy


Dissection of the duodenum


Gastro-jejunostomy


Cholecystoduodenostomy


Feeding tubes


Tips


Complications and post-operative cares


Dumping syndrome


Afferent loop syndrome


Gastritis and esophagitis


Chapter 21: Pyloroplasty


Eric Monnet


Indications


Surgical techniques


Y-U pyloroplasty


Other pyloroplasty


Pyloromyotomy


Tips


Complications


Chapter 22: Roux in Y


Eric Monnet


Indications


Surgical techniques


Roux in Y for upper GI reconstruction


Roux in Y for biliary diversion


Roux in Y for upper GI diversion


Tips


Complications and post-operative cares


Chapter 23: Gastropexy


Daniel Smeak


Indications


Surgical techniques


Tube gastropexy


Incisional gastropexy


Belt loop gastropexy


Circumcostal gastropexy


Gastrocolopexy


Incorporating gastropexy


Endoscopically assisted gastropexy


Laparoscopic assisted gastropexy


Laparoscopic gastropexy


Tips


Complications and complications


Section V: Intestine


Chapter 24: Enterotomy


Daniel Smeak


Indications


Surgical techniques


Intestinal biopsy


Enterotomy


Tips


Leak test


Reinforcement of an enterotomy


Complications and outcome


Chapter 25: Enterectomy


Daniel Smeak


Indications


Surgical techniques


Hand sewn anastomosis


Anastomosis using skin stapler


Functional end to end anastomosis with stapling equipment: open technique


One stage functional end to end anastomosis


Tips


Anatomical considerations


Handling of tissue


Utilization of linear stapler


Suture line reinforcement


Complications and outcome


Chapter 26: Enteroplication


Daniel Smeak


Indications


Surgical techniques


Complete enteroplication


Limited enteroplication


Tips


Anatomical considerations


Handling of tissue


Utilization of linear stapler


Suture line reinforcement


Complications and outcome


Section VI: Colon


Chapter 27: Colectomy


Daniel Smeak and Eric Monnet


Indications


Surgical techniques


Preoperative considerations


Surgical procedures


Colonic anastomosis closure methods


Surgical techniques


Tips


Postoperative considerations and prognosis


Chapter 28: Colotomy


Daniel Smeak


Indications


Surgical techniques


Preoperative considerations


Surgical procedure


Tips


Postoperative considerations and prognosis


Chapter 29: Thyplectomy


Daniel Smeak


Indications


Surgical techniques


Simple typhlectomy


Colotomy and typhlectomy


Ileocolic resection and anastomosis


Tips


Postoperative considerations and prognosis


Chapter 30: Colostomy


Daniel Smeak


Indications


Surgical techniques


Flank diverting loop rod-supported colostomy


End on colostomy


Laparoscopic assisted end-on jejunostomy


Tips


Postoperative considerations and prognosis


Chapter 31 Colopexy


Daniel Smeak


Indications


Surgical techniques


Standard ventral midline approach


Paramedian incorporating


Laparoscopic colopexy


Laparoscopic assisted colopexy


Tips


Postoperative care and complications


Section VII: Rectum and anal sac


Chapter 32: Approaches to the rectum


Daniel Smeak


Indications


Surgical approaches to the rectum


Dorsal approach


Lateral approach


Ventral approach with pubic osteotomy


Postoperative care and complications


Chapter 33: Surgery of the rectum


Daniel Smeak


Indications


Surgical techniques


Transanal technique


Combined transanal and abdominal techniques


Tips


Postoperative care and complications


Chapter 34: Anal sac resection


Daniel Smeak


Indications


Surgical techniques


Preparation and positioning of the patient


Open techniques


Closed techniques


Closed techniques for anal sac neoplasia


Tips


Postoperative care and complications


Section IV: Liver and gall bladder


Chapter 35: Liver lobectomy


Eric Monnet


Indications


Surgical techniques


Liver biopsy


Laparotomy


Laparoscopy


Partial liver lobectomy


Complete liver lobectomy


Liver lobectomy with sutures


Liver lobectomy with staples


Tips


Complications


Chapter 36: Surgery of the gall bladder


Eric Monnet


Indications


Surgical techniques


Cholecystostomy


Cholecystotomy


Cholecystectomy


Laparotomy


Laparoscopy


Tips


Complications and postoperative care


Chapter 37: Biliary diversion


Eric Monnet


Indications


Surgical techniques


Temporary bile diversion


Temporary cholecystostomy tube during laparotomy


Temporary cholecystostomy tube with laparoscopy


Permanent biliary diversion


Cholecystoduodenostomy


Roux in Y diversion


Cholecystojejunostomy


Choledochoduodenostomy or choledochojejunostomy


Tips


Complications


Chapter 38: Surgery of the bile duct


Eric Monnet


Indications


Surgical techniques


Choledochotomy


Resection anastomosis of the common bile duct


Choledochoduodenostomy or choledochojejunostomy


Complications


Chapter 39: Biliary stenting


Eric Monnet


Indications


Surgical techniques


Short term temporary stenting


Long term temporary stenting


Permanent stenting


Tips


Complications and post-operative cares


Chapter 40: Arterio-venous fistula


Eric Monnet


Indications


Surgical techniques


Laparotomy


Interventional radiology


Tips


Complications


Chapter 41: Portosystemic shunts


Eric Monnet


Indications


Surgical techniques


Extraheaptic shunt


Identification


Dissection


Intraheaptic shunt


Identification


Dissection


Techniques for ligation or progressive occlusion of the shunt


Techniques resulting in fixed attenuation of a shunt


Techniques resulting in slow progressive and complete occlusion of a shunt


Tips


Complications


Post-operative complications and short term outcome


Long term complications and outcome


Section V: Pancreas


Chapter 42: Surgery of the pancreas


Daniel Smeak


Indications


Surgical procedures


Pancreatic biopsy


Nodulectomy


Partial pancreatectomy


Total pancreatectomy


Pancreatic drainage


Tips


Post-operative care and complications