AN INTRODUCTION TO EXPLORATORY LAPAROTOMY WHAT IS AN

AN INTRODUCTION TO EXPLORATORY LAPAROTOMY

WHAT IS AN EXPLORATORY LAPAROTOMY? • An exploratory laparotomy is a minimally invasive surgical procedure involving the opening of the abdominal cavity and examination of the abdominal organs. It is used in for the diagnosis of intra-abdominal diseases through direct inspection of intra-abdominal organs as well as pelvic organs. • Exploratory laparoscopy also allows tissue biopsy, culture acquisition, and a variety of therapeutic interventions.

LEFT PARALUMBAR APPROACH • Laparotomy is commonly performed either for exploratory purposes when a clinical diagnosis is still uncertain or for a specific purpose when a clinical diagnosis has already been made for cesarean section or rumenotomy (indicated for esophageal obstruction or free gas bloat). • Flank laparotomy through the left paralumbar fossa is commonly used for exploratory laparotomy if a problem is suspected on the left side- the procedure is specifically indicated for left-sided abomasopexy, rumenotomy and caesarian section.

RIGHT PARALUMBAR APPROACH • The right paralumbar approach is used for exploratory laparotomy if a problem is suspected on the right side, and is specifically indicated for surgical conditions of the abomasum, including right-sided omentopexy or abomasopexy, small intestine, caecum and colon. The right paralumbar approach will provide the best access to the abdomen and the most complete exploratory in the adult ruminant.

RIGHT PARALUMBAR APPROACH • A right-flank approach may also be used for cesarean section when ruminal distention or right-sided positioning of the fetus causes the surgeon to consider the right side a superior approach to the left side.

RELEVANT ANATOMY • In the ruminant, the most cranial forestomach, the reticulum, lies just caudal to the diaphragm and to the left of the midline, beneath the 6 th through 8 th ribs. The space left of the median, from approximately the 7 th or 8 th rib to the pelvis, is occupied by the rumen. • On the right side of the ruminant lie the omasum and the elongated true stomach, the abomasum. The omasum lies near the ventral aspect of the 7 th and 11 th ribs, and the abomasum extends from the xiphoid region to the 9 th or 10 th rib, occupying primarily the right side except for the fundus which deviates to the ventral aspect of the rumen atrium.

RELEVANT ANATOMY

RELEVANT ANATOMY

RELEVANT ANATOMY

INDICATIONS FOR AN EXPLORATORY LAPAROTOMY-GENERAL • An abdominal exploratory is indicated whenever there is significant abdominal disease that eludes diagnosis such as: – Chronic Vomiting – Penetrating Abdominal Wounds – Abdominal Pain – Abdominal Fluid Accumulation – Urinary Bladder Disease – Abdominal Masses – Intestinal diseases

INDICATIONS FOR AN EXPLORATORY LAPAROTOMY- COMPANION ANIMALS • The most common indication in the companion animal practice is the ovariectomy or the ovariohysterectomy.

INDICATIONS FOR AN EXPLORATORY LAPAROTOMY- RUMINANTS • The most important indications for a laparotomy in ruminants are: – The surgical treatment of abnormalities of the digestive tract, for example, abomasal displacement. – Surgical procedures to the urogenital system, such as Caesarean section

INDICATIONS FOR AN EXPLORATORY LAPAROTOMY- EQUINE • The most important indications for a laparotomy in the horse are: – Surgical treatment of abnormalities of the digestive tract, for example, displacements, strangulations, obstructions etc. – Surgical procedures to the urogenital apparatus such as: • In the mare: Caesarean section, ovariectomy, repositioning of a uterine torsion • Stallion or gelding: Removal of abdominal testicles, removal of bladder stones, closing of ruptures to the