BULE HORA UNIVERSITY

College of Agriculture and Veterinary Science

Department of Veterinary Medicine

Veterinary General surgery and Anesthesiology

Lecture Note

Prepared by:

Dr. Zerihun Mulatu (DVM, MVSc, Assist. Professor of

Veterinary Surgery)

Bule Hora, Ethiopia

Friday, April 19, 2024 Bule Hora University 1
 Chapter One
Definition of Surgery
 Surgery is a branch of medical science which deals with
therapeutics of a disease or injury
o With manipulative or operative methods alone or

o In combination with other pharmaceutical modalities

 The etymology of the word ‘surgery’

o Latin synonym is ‘chirurgia’ of which the Greek synonym is

‘cheirourgia’
o Semantic of cheir (hand) and ergon (to work).

 The Oxford University Dictionary

o “The art and practice of treating injuries, deformities and

other disorders by manual operations or instrumental

appliances”.

Friday, April 19, 2024 Bule Hora University 2

 Cont’d…
 A Surgeon must be a clinician trained in surgical skills with
adequate knowledge of allied sciences like:
 Anatomy,

 Physiology,

 Pathology,

 Pharmacology,

 Medicine

 Gynecology & Obstetrics,

 Anesthesiology,

 Radiology, Microbiology, Sterilization, Shock

Management, Fluid Therapy, Chemotherapy And Nutrition
 Veterinary surgery is surgery practiced on animals
Friday, April 19, 2024 Bule Hora University 3
 History of Veterinary Surgery
 The evolution of medical and veterinary science and surgery are
intimately interlinked.
 Veterinary practice is perhaps as old as the civilization itself.
 History dictates that vet. surgery originates from human
surgery
 Historians believe that medicine and surgery date back to
about 6, 000 B.C.
 Egyptians and Greeks made contributions to medical and
veterinary profession.
o Treatment of fractures and superficial wounds were

recorded on the papyri of Egypt.

o In Greece, Hippocrates (460-370 B.C.) taught surgery.
o A treatise on dog was written in 284 B.C. in Greece.

Friday, April 19, 2024 Bule Hora University 4

 Cont’d…
 The earliest known surgeon used large amount of tools:
 Knives, awls, drills, scissors, saws, forceps, clamps,
syringes, needles, splints, & bandages.
 They even had prosthetic devices like artificial limbs
made of wood and metal.
 Modern surgery
 Major achievements that made modern surgery
possible:
o The development of anesthesia, microbiology and

discovery of antibiotics
o Real progress came after the discovery of aseptic

principles and anesthesia.

Friday, April 19, 2024 Bule Hora University 5

 Objectives of surgery
 To restore animal’s functions to as near normalcy as possible
 To eliminate life threatening maladies (choke, acute intestinal
obstruction etc)
 To remove diseased part (amputaion of a gangrenous tail, extraction
of diseased tooth) and removal of foreign bodies (ruminotomy)
 To render the animal less dangerous to human being (e.g. castration
and dehorning)
 To aid in diagnosis of suspected pathological process (exploratory
laparotomy)
 To increase productivity and the ability of the animal to work
 For aesthetic/cosmetic reason (e.g. supernumerary teats removal, ear
trimming and docking)
 For investigation in research work/experimental surgery (e.g. gastric
fistula)
Friday, April 19, 2024 Bule Hora University 6
 Veterinary Surgery Terminology
 Most veterinary surgery terms describing procedures are
composed of a prefix and a suffix.

 The prefix is the first part of the word, which usually

refers to the organ or structure that is involved.

 The suffix is the last part of the word and often denotes
the type of procedure.

 For example, a thoracotomy (a surgical procedure

involving an incision in the thorax) can be divided into
the prefix: thoraco- and the suffix -otomy.

Friday, April 19, 2024 Bule Hora University 7

 Cont’d…
 -OTOMY: A surgical procedure in which a structure is
cut.

 Gastrotomy: is a procedure in which an incision(-otomy) is

made into the stomach (gastro-).

 Cystotomy: is a procedure in which an incision (-otomy) is

made into the urinary bladder(cysto-).

 Celiotomy: A celiotomy is a procedure in which an incision (-

otomy) is made through the abdominal
wall (celio-), usually through the midline.

 Laparotomy: is used interchangeably but it actually

describes an abdominal approach through a flank incision.
Friday, April 19, 2024 Bule Hora University 8
 Cont’d…
 -ECTOMY: A surgical procedure in which a portion
of tissue is removed? resected.

 Ovariohysterectomy: is a procedure in which the

ovaries (ovario-) and uterus (-hyster-) are surgically
removed (-ectomy).

 Femoral Head and Neck Ostectomy: is a procedure in

which the head and neck of the femur are surgically
removed(-ectomy).

Friday, April 19, 2024 Bule Hora University 9

 Cont’d…
 -STOMY: A surgical procedure in which a new opening is created
on a temporary or permanent basis.

 Tracheostomy: is a procedure in which a new permanent

opening ostomy) is created through the skin of the neck into
the trachea (tracheo).

 Gastrostomy: is a procedure in which a tube is placed

through the body wall and into the stomach in order to create
a new temporary opening in the stomach.

 Urethrostomy: is a procedure in which a new permanent

opening (-ostomy) is created in the urethra (urethro-) that
communicates with the skin.
Friday, April 19, 2024 Bule Hora University 10
 Cont’d…
 -PLASTY: A surgical procedure in which an alteration is
performed to an organ or body structure, it is usually permanent.

 The term “-plasty” is also used as a suffix when an artificial

prosthesis is implanted to replace an original body part.

 Cheiloplasty: is a surgical procedure that involves the

repair or surgical modification (-plasty) of the lip (cheilo-).

 Vulvoplasty: is a surgical procedure that surgically changes

the shape (-plasty) of the vulva (vulvo-). This procedure is
often performed to correct an underdeveloped vulva or a
vulva that is recessed due to excessive perineal fat in an
overweight patient.
Friday, April 19, 2024 Bule Hora University 11
 Cont’d…
 -PEXY: A surgical procedure in which a permanent or
temporary adhesion is created between two structures
(usually using suture, sometimes using a tube).

 Gastropexy: is a procedure in which the stomach

(gastro-) is affixed (-pexy) to the abdominal wall. This
procedure is typically performed to prevent the
recurrence of gastric dilatation volvulus (GDV) in dogs.

 Abomasopexy: is a procedure in which the abomasium

(Abomaso-) is affixed (-pexy) to the abomasal wall or its
attached omentum to the abdominal wall.

Friday, April 19, 2024 Bule Hora University 12

 Cont’d…
 -OSCOPY: A surgical procedure involving the use
of an optical instrument (an endoscope, an otoscope, an
arthroscope, etc.) to visualize organs or structures.
Laparoscopy:

 Laparoscopy: is a procedure in which an optical

instrument (laparoscope) is used to
visualize the abdominal organs (laparo-) in a
minimally invasive manner.

 Arthroscopy: is a procedure for diagnosing and

treating joint problems.

Friday, April 19, 2024 Bule Hora University 13

 Cont’d…
 -RRHAPHY: A surgical procedure in which a structure is
sutured or repaired.

 Herniorraphy: it describes the surgical repair (-

rrhaphy) of a hernia (hernio-).

 Cystorrhaphy: is the surgical repair (-rrhaphy) of a

tear in the bladder wall (cysto-).

Friday, April 19, 2024 Bule Hora University 14

 Cont’d…
 -CENTESIS: is a surgical procedure in which a cavity
or structure is punctured in order to aspirate fluid, air or tissue.
 Paracentesis is sometimes used synonymously.

 Abdominoscentesis: involves puncture (-centesis) of

the abdominal cavity (abdomino-) using a small trocar or
needle and is typically performed to aspirate
free abdominal fluid (also known as effusion).

 Throacocentesis: involves puncture (-centesis) of the

thoracic cavity (thoraco-) in order to aspirate free fluid or
air

Friday, April 19, 2024 Bule Hora University 15

 Classification of Surgery
A. According to the Nature of Surgery
 General /restorative surgery:
 Carried out to restore the normal function of the body
or a part without substituting or discarding and part of
the body. E.g. rumenotomy
 Extirpative surgery:
 Involves the removal of a part
 E.g. hysterectomy.

 Replacement surgery
 Replacement of a diseased part by either a living tissue
(vascular graft) or dead tissue (corneal or bone graft)

Friday, April 19, 2024 Bule Hora University 16

 Cont’d…
 Diagnostic (Exploratory ) surgery
 Surgery done to arrive at a diagnosis (biopsy,
paracentesis)
 Major surgery
 Relatively more difficult to perform
 Time consuming
 Involves risk on the life of the patient
 Requires the help of an assistant
E.g. Cesarean section, thoracic surgery

Friday, April 19, 2024 Bule Hora University 17

 Cont’d…
 Minor surgery
 Relatively simple to perform
 Having no risk on the life of the animal
 Does not require the services of an assistant
E.g. Lancing an abscess
 Radical surgery
 The root cause or source of a disease condition is removed

or rectified
 E.g. Hernial repair, Enucleation of a tumor

Friday, April 19, 2024 Bule Hora University 18

 Cont’d…

 Plastic surgery
 Done on aesthetic grounds or to restore disturbed function

 Reconstructive surgery
o Surgery done for correction of deformities
o Example: surgery for cleft palate
 Cosmetic surgery
o Improve the appearance
o Satisfy the fancy and sentiments of the
owner. Example: ear cropping, tail docking
Friday, April 19, 2024 Bule Hora University 19
 B. Based on their urgency
 Elective surgery

 Performed when circumstances are favorable in

terms of time as well as in terms of the patient
 Spaying, castration
 Emergency surgery

 It requires immediate intervention without spending

time
 It is performed and recommended in case of profuse
hemorrhage, perforation of visceral organs, sever
tympanyBuleofHorathe
Friday, April 19, 2024
rumen
University 20
 C. Based on Region or System Involved

 Advancement in surgery has lead to this classification and

surgeons specialize on a particular region or system
 Orthopedic surgery
 Ophthalmic surgery
 Thoracic surgery
 Cardiovascular surgery
 Neurosurgery

Friday, April 19, 2024 Bule Hora University 21

 D. Based on Instruments & Appliances
 General surgery
 used when only the common surgical instruments used in the
procedure. E.g. Castration
 Microsurgery
 magnification facilities are used for specialized surgical
procedures. E.g. Vascular anastomosis
 Cryosurgery
 Use of substances like liquid nitrogen which produces freezing
temperatures to destroy abnormal tissues. E.g. Removal of
warts
Friday, April 19, 2024 Bule Hora University 22
 Cont’d…

 Electrosurgery
 Electricity is converted to heat to incise a tissue
 Excision of small tumors using electrocautery
 Laser surgery
 laser beams are used to cut or destroy the diseased
tissue
Ultrasonic surgery
High frequency waves are used to destroy a particular
tissue or a substance
E.g. Lithotripsy

Friday, April 19, 2024 Bule Hora University 23

 Cont’d…
 Principles of Modern Surgery
 Gentle handling of tissues
 Aseptic surgery
 Anatomical dissection
 Control of Hemorrhage
 Obliteration of dead space
 Use of minimum quantity of suture material
 Avoidance of suture tension
 Immobilization

Friday, April 19, 2024 Bule Hora University 24

 Considerations in surgery
A. Pre-operative (pre-surgical) considerations
 Objectives
 To strive for sterile techniques in terms of :
 Sterilzationmethod of instruments
 Hand preparation and sterile glove technique

 Patient preparation

 Draping

 Maintaining a sterile field intra-operatively

 Operative room management

Friday, April 19, 2024 Bule Hora University 25

 Cont’d…
 Vital pre-surgical considerations
 A surgeon must keep certain considerations related to:

 the owner
 the patient
 the surgeon himself in mind before undertaking
surgery

Friday, April 19, 2024 Bule Hora University 26

 Cont’d…
A. The Owner
 The owner is the custodian and provider of the animal’s needs
and therefore has a legal right over his/her animal
 A veterinarian is legally answerable to the owner and must
inform him/her the disease, proposed surgical treatment and the
possible outcome
 The owner must be convinced that everything is being done in
the interest of the patient
 The owner-patient-surgeon relationship becomes very
important to maintain a good rapport
 A surgeon must also consider economic aspects of the case,
surgical risk involved, ethics and sentiments of the owner
Friday, April 19, 2024 Bule Hora University 27
 Cont’d…
B. The Patient
Identification:
 It is imperative to properly record the:
 Identification of the patient with name of the owner
 Surgery to be performed
 Exact part to be operated
 Operating wrong patient or performing surgery on a wrong
leg in the open yard system will lead to lot of confusion
History of the patient:
 Should gather full information on the history of the animal
 This may help us to screen out whether the animal is fit or not
for the operation to be performed
Friday, April 19, 2024 Bule Hora University 28
 Cont’d…
Body condition of the patient:
 The patient must be carefully examined to ascertain whether it is
a fit subject for operation
 Whether it is debilitated or affected with some condition which
renders the operation risk greater than usual
 Physical examination, Laboratory tests, Restraining and
Pre-surgical fasting
C. The Surgeon
 A surgeon must develop his surgical skills and learn from each
and every surgical procedure which forms a basis for sound
judgment
 Judgment means rational analysis for a good decision, whether
to operate or not and when to operate, form a part of a surgical
judgment
Friday, April 19, 2024 Bule Hora University 29
 Cont’d…
 A surgeon who recognizes his short comings, learns from
failures of his own and of others, develops a better judgment
 A surgeon has to be bold
 He must have the eyes of an eagle, fingers of ladies and the
heart of a lion
 Planning: A surgeon must be familiar with the surgical
anatomy of the part and the surgical procedure
 In case of doubt, referring the book will give guidance and
confidence
 He must ensure that all equipments, drugs and other items have
been arranged properly
 A better approach is to mentally visualize the operation to be
done and to make a check list of all items required
Friday, April 19, 2024 Bule Hora University 30
 Cont’d…
B. Intra operative considerations
 Objectives
 To avoid of anesthetic risk and depth
 Recognize abnormal findings that may make surgery

contraindicated
 Methods of monitoring anesthetic depth

 Criteria for changing the depth of anesthesia

 Manage and monitor recovery process

Friday, April 19, 2024 Bule Hora University 31

 Cont’d…
C. Post-operative (post surgical) considerations
 Objectives
 To prevent post-operative infection and pain
 To provide post-operative patients care
 The level of monitoring each patient needs during the recovery
period will depend on:
 The age and general health of the patient
 The nature of the surgery performed, and the anaesthetics or
sedative used
 Any complications that may have occurred during surgery
(e.g. blood loss, anaesthetic problems)
 The presence of any surgical implants (e.g. drains,
orthopaedic implants)
Friday, April 19, 2024 Bule Hora University 32
 Cont’d…
 Common postoperative complications following surgery
include:
 Wound infections or breakdown
 Mainly a result of failure of applying aseptic technique

 Suture reactions
 Common when natural absorbable sutures are used

 Seroma/haematoma formation
 Occurs when dead space has been insufficiently closed
during wound repair
 Patient discomfort/pain and self-trauma of surgical site
 Caused by inadequate analgesia, inflammation or
infection
Friday, April 19, 2024 Bule Hora University 33
 Cont’d…
 Most postoperative anaesthetic deaths occur due to
airway occlusion (through emesis, saliva or occlusion
from poor positioning).
 So the patient should be constantly monitored until it is
able to maintain itself in sternal recumbency and raise
its head
Once in sternal recumbency, the risk of
inadvertent occlusion of the airway due to body
position is small
 The patient should be checked at least every 5 min and
preferably kept in line of vision for some while after the
animal is able to maintain sternal recumbency

Friday, April 19, 2024 Bule Hora University 34

 Cont’d…
 Common post-operative cares include:
 Administration of antibiotics and analgesics
 Close monitoring of the surgical wound for haemorrhage and
taking appropriate measure
 Wound dressing or bandaging and change
dressings/bandages if necessary
 Intravenous (IV) fluid therapy
 Should be maintained until the patient is able to drink or
eat (or until hydration has been restored in ill patients)
 Elizabethan collars application to reduce the risk of self
mutilation and premature suture removal
 Food and water should be withheld from the patient until it is
able to stand

Friday, April 19, 2024 Bule Hora University 35