Small Animal Surgical Emergencies. Группа авторов
Tracheostomy tube (multiple sizes)
3‐0 nylon suture material
Stay suture labels
Small gelpi retractor
Tracheal hook retractor or Senn retractors
Tracheal tube holder set or umbilical tape
Sterile gloves
Sterile drape
Figure 2.18 Tape straps are placed behind the patient's canine teeth to allow the mouth to hang open for visualization of the soft palate and laryngeal saccules.
Box 2.11 Instrumentation Recommended for Arytenoid Cartilage Lateralization
Routine soft tissue instrument set
Bipolar cautery
Senn retractors
Gelpi retractor
2‐0 Prolene, RB‐1, 17 mm taper double armed
Box 2.12 Instruments for a Lateral Thoracotomy
Routine soft tissue instrument set
Sterile suction tubing
Suction canister
Monopolar and bipolar cautery
Finochietto rib retractor (Figure 2.19)
Stapling equipment (Figures 2.3 and 2.20, Table 2.1)
Bipolar vessel sealing device (LigaSure®; Figure 2.4)
Hemoclips, Ligaclips, or Surgiclips (Figure 2.5)
Vetspon absorbable hemostatic gelatin sponge (gel foam)
Oxidized regenerated cellulose (Surgicel)
Equipment necessary for chest tube placement (Figure 2.21)
Suture material for thoracotomy closure
Figure 2.19 Finochietto rib retractors, which are supplied in multiple sizes ranging from small to extra large.
Figure 2.20 Use of a TA30 stapling device for a lung lobectomy.
Pericardiectomy
The pericardium can be accessed via a lateral thoracotomy or a median sternotomy. The surgical approach will depend on the cause of the pericardial effusion. If a median sternotomy is being performed, a V‐trough, sandbags, and leg positioners will be helpful in proper positioning. Sterile tongue depressors can be used to aide in protection of vital heart structures while performing the pericardiectomy. Once the pericardium has been entered, the tongue depressor is applied between the epicardium and the cautery tip to prevent injury. Instruments recommended for either a lateral thoracotomy or median sternotomy are listed in Boxes 2.12 and 2.13. Additional instruments recommended for a pericardiectomy are listed in Box 2.15.
Box 2.13 Instrumentation to Perform a Sternotomy
Sagittal or sternal saw
0‐polydioxanone sutures for small dogs weighing less than 15 kg and cats
Sternal wire for dogs > 20 kg (Figure 2.22)
Wire twister
Wire cutter
Figure 2.21 Chest tube instrumentation for thoracic cavity evacuation including a fluted round chest tube with trocar (assortment of sizes), 20–60‐cc syringe, three‐way stopcock, and catheter adapter.
Figure 2.22 Sternal thoracotomy instrumentation, including sternal wire with loops and swaged on needle, wire cutters, and wire twister.
Figure 2.23 Parker Kerr retractors.
Box 2.14 Instruments for Pericardiocentesis
Electrocardiogram
14–18 g needle or over‐the‐needle catheter, based on the size of the patient
Sterile gloves
Three‐way stopcock, extension tubing and a syringe (20–60 ml based on patient size; see Figure 34.3)
Reproductive System
Cesarean Section
The surgical approach for a cesarean section is a ventral midline celiotomy. The patient is positioned in dorsal recumbency. For very large dogs, the patient can be tilted 10–15 degrees to the side to remove the weight of the gravid uterus from the caudal vena cava. Instruments for cesarean