Efficient Spay Neuter Techniques :Efficient Spay Neuter Techniques Phil Bushby, DVM, MS, ACVS Marcia Lane Endowed Professor of Humane Ethics and Animal Welfare College of Veterinary Medicine Mississippi State University


Introduction :Introduction Surgical techniques used in high volume spay neuter clinics are: Efficient Safe Fundamentally different from those taught in veterinary school


We will look at: :We will look at: Helpful hints Where does the surgeon stand? Positioning of the patient Placement of the incision Ligation techniques Hand ties Pedicle ties Millers knot Pediatric techniques


Where does the surgeon stand? :Where does the surgeon stand?


Where does the surgeon stand? :Where does the surgeon stand? The surgeon should stand with the animal’s head on the side of their dominant hand. So if you are right-handed stand with the cat’s head to your right. If you are left-handed stand with the cat’s head to your left.


A Hint :A Hint


Patient Positioning :Patient Positioning


Patient Positioning :Patient Positioning


Patient Positioning :Patient Positioning


Patient Positioning :Patient Positioning


Placement of Incision for spays :Placement of Incision for spays


Placement of Incision: Cat spay :Placement of Incision: Cat spay Midpoint between umbilicus and anterior brim of the pubis


Placement of Incision: Adult dog spay :Placement of Incision: Adult dog spay Cranial third of the space between umbilicus and anterior brim of the pubis.


But :But Enter abdominal cavity slightly right paramedian.


Placement of Incision: Adult spay :Placement of Incision: Adult spay Second fourth of the space between umbilicus and anterior brim of the pubis


Placement of Incision: Cat spay :Placement of Incision: Cat spay Second fourth of the space between umbilicus and anterior brim of the pubis


Placement of Incision: Puppy spay :Placement of Incision: Puppy spay Second fourth of the space between umbilicus and anterior brim of the pubis


Castration incisions :Castration incisions Scrotal Cats Puppies Adult dogs


Ligation techniques :Ligation techniques Single ligatures Transect the tissue first


Finding uterus / Expose 1st ovary :Finding uterus / Expose 1st ovary Once you have the uterus (or broad ligament) Grasp with fingers and gentle tension exteriorizes 1st ovary


Exteriorize ovary :Exteriorize ovary Cut suspensory ligament with scissors and Tear a hole in the broad ligament. Further exteriorizing ovary


3 Clamp Technique :3 Clamp Technique Place 1st hemostat proximal. Close 1 click. Place 2nd hemostat between 1st and ovary. 2 clicks.


3 Clamp Technique / Transect ovarian pedicle :3 Clamp Technique / Transect ovarian pedicle And 3rd hemostat between ovary and uterine horn. 3 clicks Place gauze sponge behind pedicle. Cut on top of # 2.


Ligate ovarian pedicle :Ligate ovarian pedicle Reflect uterine horn & ovary caudally Ligate in crushed area from 1st hemostat. HAND TIE!


Hand tie-Square Knot :Hand tie-Square Knot


Hand tie-Surgeon’s Knot :Hand tie-Surgeon’s Knot


Pedicle Tie :Pedicle Tie


Miller’s Knot – Instrument tie :Miller’s Knot – Instrument tie


Miller’s Knot – Hand tie :Miller’s Knot – Hand tie


Pediatric Surgeries :Pediatric Surgeries As young as 6 to 8 weeks in the Shelter environment More realistically 4 to 5 months in practice Allows animals to receive full vaccination series prior to surgery. Still sterilize prior to sexual maturity Easier Faster Quicker recovery


So lets put these all together: :So lets put these all together:


Cat castration :Cat castration


Cat spay :Cat spay


Puppy Castration :Puppy Castration


Puppy Spay :Puppy Spay


Adult dog castration :Adult dog castration


Adult dog spay :Adult dog spay


Adult dog spay :Adult dog spay


Questions :Questions