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This Concept Map, created with IHMC CmapTools, has information related to: Ex Lap Procedure, The muscle layer is checked by using the index finger for weak areas which may allow herniation. These areas are reinforced with simple interrupted sutures. 9 The skin is then closed useing a Ford interlocking pattern but stopped approximately 1 inch before the end of the incision. The rest of the incision is then closed using simple interrupted sutures. *, The abdominal wall was then closed. The peritoneum, transversus abdominus, internal abdominal oblique and external abdominal oblique were then sutured closed. Sututre material and technique Suture techniques include: simple continuous, horizontal/vertical mattress, simple interrupted Remember to take bit bites and the muscle fascia, not the muscle had the holding strength. Size 0, 1 or 2 suture material is usually used. PDS, Vicryl, etc can be used, The skin is then closed useing a Ford interlocking pattern but stopped approximately 1 inch before the end of the incision. The rest of the incision is then closed using simple interrupted sutures. * using Ford interlocking pattern can be substituted by: crucriate, simple continuous, horizontal/ vertical mattress, etc. techniques; using either 1, 2 or 3 non absorable (nylon, prolene, etc.) suture material, The duodenum is identified and the viscea is palpated in situ (refer to the map). Reaching as far cranial as possible the cardiac contractions can be felt against the tendenious part of the diaphram. * 4 a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation)., The subcutaneous is bluntly dissected and blood vessels are either clamped (using haemostats) or ligated using catgut. The muscule layers are then carefully identified and transected individually. When the transversus abdominus muscle is arrived at, the muscle layer is tented and inscised, a mayo scissors is used to inscise the muscle layer with the scissors pointed upward to avoid cutting the viscera. * 3 The duodenum is identified and the viscea is palpated in situ (refer to the map). Reaching as far cranial as possible the cardiac contractions can be felt against the tendenious part of the diaphram. *, a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation). remember Remember to keep the viscera moist with sterile saline, this would reduce serosal tramua => ahdesions, The duodenum is traced from the pylorus to the highly coiled jejuneum the the the illeum which joins the LI via the illio-caeco-collic junction. You can then palpate the caecum and it's blind sac, the proximal, spiral loop and distal ascending colon, the transverse colon and the descending colon are all palpated. 6 If no pathology is found the organs are carefully replaced in reverse order, The abdominal wall was then closed. The peritoneum, transversus abdominus, internal abdominal oblique and external abdominal oblique were then sutured closed. variation in cattle In cattle, the peritoneum and transversus abdominus muscle is closed separately, then the internal and external abdominal oblique +/- subcutaneous layers are closed, The skin is then closed useing a Ford interlocking pattern but stopped approximately 1 inch before the end of the incision. The rest of the incision is then closed using simple interrupted sutures. * closure using Skin closure was mainly done without additional anesthetic. Only LA (splash block) was used, a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation). remember wash off any glove powder residue and lubricate your hands with saline before palpating, The abdominal wall was then closed. The peritoneum, transversus abdominus, internal abdominal oblique and external abdominal oblique were then sutured closed. 8 The muscle layer is checked by using the index finger for weak areas which may allow herniation. These areas are reinforced with simple interrupted sutures., a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation). pain relief by Abdominal viscera are extremely sensitive therefore a 1% solution of lidocaine was used as splash block to prevent painful stimuli *, The skin is then closed useing a Ford interlocking pattern but stopped approximately 1 inch before the end of the incision. The rest of the incision is then closed using simple interrupted sutures. * 10 The surgical site is then cleaned wth saline and excess blood removed an antibiotic spray (tetrevet) followed by a bandage spray (allospray) and antimyiasis spray (larvicid) was applied. The animal is then placed in sternal recumbency to allow eructation., The duodenum is traced from the pylorus to the highly coiled jejuneum the the the illeum which joins the LI via the illio-caeco-collic junction. You can then palpate the caecum and it's blind sac, the proximal, spiral loop and distal ascending colon, the transverse colon and the descending colon are all palpated. pain relief by Abdominal viscera are extremely sensitive therefore a 1% solution of lidocaine was used as splash block to prevent painful stimuli *, Remember to lay out your instruments, perform a surgical srub, and drape your patient * 1 Following a surgical scrub, a 20cm skin incision is made midway between the last rib and the tuber coxae ventral to the transverse processes of the lumbar vertebrae, a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation). remember Avoid damage to the arterial blood supply (Cranial mesenteric A. and the colateral branch of the cranial mesenteric A, Following a surgical scrub, a 20cm skin incision is made midway between the last rib and the tuber coxae ventral to the transverse processes of the lumbar vertebrae cattle variation Remember: this procedure is usually done standing in cattle used the distal/proximal paravertebral nerve block, Following a surgical scrub, a 20cm skin incision is made midway between the last rib and the tuber coxae ventral to the transverse processes of the lumbar vertebrae 2 The subcutaneous is bluntly dissected and blood vessels are either clamped (using haemostats) or ligated using catgut. The muscule layers are then carefully identified and transected individually. When the transversus abdominus muscle is arrived at, the muscle layer is tented and inscised, a mayo scissors is used to inscise the muscle layer with the scissors pointed upward to avoid cutting the viscera. *, If no pathology is found the organs are carefully replaced in reverse order 7 The abdominal wall was then closed. The peritoneum, transversus abdominus, internal abdominal oblique and external abdominal oblique were then sutured closed., a sterlile towel should be laid out and the viscera exteriorized. The variouss organs and parts of the GIT are identified and inspected for pathology (visual and palpation). 5 The duodenum is traced from the pylorus to the highly coiled jejuneum the the the illeum which joins the LI via the illio-caeco-collic junction. You can then palpate the caecum and it's blind sac, the proximal, spiral loop and distal ascending colon, the transverse colon and the descending colon are all palpated.