Surgery - Orchiectomy And Scrotal Ablation

Front 1

Orchiectomy
-indications for procedure

Back 1

-reduction of overpopulation
-prevention of prostatic disease (abscess, hyperplasia, cyst)
-Cryptorchidism
-Testicular neoplasia
-Orchitis/Epididymitis
-Testicular torsion
-other androgen related disease
-behavior

Front 2

Why is orchiectomy not indicated for prostatic neoplasms?

Back 2

-prostatic neoplasms are androgen dependent, so risk won't be decreased

Front 3

Cryptorchidism
-possible effects

Back 3

-heritable condition
-reduced fertility
-neoplastic transformation
-risk of torsion

Front 4

Testicular neoplasia
-types (tissue of origin)

Back 4

-Seminoma (germinal epithelium)
-Interstitial cell tumor (leydig cell)
-Sertoli cell (seminiferous tubules)

Front 5

Testicular neoplasia
-signs

Back 5

-local swelling
-atrophy of contralateral testicle

feminization (if a functional neoplasm)
-alopecia
-gynecomastia
-penile/preputial changes (penile atrophy, pendulous prepuce)
-myelosuppression

Front 6

Orchitis/Epididymitis
-causes

Back 6

-bacterial (brucella)
-viral (distemper)
-fungal
-rickettsial
-secondary (ascending infection)

Front 7

Testicular torsion
-due to

Back 7

-abdominally located testicles

Front 8

"Other" androgen related disease of the testicles

Back 8

-perianal adenoma
-perineal hernia

Front 9

Orchiectomy
-important anatomy

Back 9

-Testes, Epididymis
-Ligaments (Proper ligament, Tail of Epididymis)
-Spermatic Cord (ductus deferens, testicular and ductus deferens arteries, pampiniform plexus)
-cremaster muscle
-spermatic fascia (external, internal)
-parietal vaginal tunic

Front 10

Proper ligament of the testis
-location

Back 10

-caudal testis

Front 11

Ligament of the tail of the epididymis
-location

Back 11

-attached to the parietal vaginal tunic

Front 12

Parietal vaginal tunic
-importance

Back 12

-invagination of the peritoneum
-difference between closed/open castrations

Front 13

Orchiectomy
-important surgical notes for dog

Back 13

-scrotum not shaved
-scrotum not draped in surgical field
-testicle manipulated with non-dominant hand (stand on left side of dog)
-pre-scrotal incision

Front 14

Dog castration
-what to be careful of with pre-scrotal incision

Back 14

-don't incise scrotum or penile urethra

Front 15

Orchiectomy
-important surgical notes for dog

Back 15

-scrotum plucked of hair
-scrotum draped in surgical field
-incision in scrotum parallel to median septum

Front 16

Closed castration
-indication

Back 16

-dog < 20 kg

Front 17

closed castration
-what is being incised

Back 17

-subcutaneous tissue
-spermatic fascia

*parietal vaginal tunic intact

Front 18

Castration
-how to enhance exteriorization of testicle

Back 18

-strip spermatic cord

-break down ligament of the tail of the epididymis
-remove as much fat as possible

Front 19

Castration
-ligature technique

Back 19

-triple clamp

*tips of carmalts toward ceiling

Front 20

Closed castration
-where to transect spermatic cord

Back 20

-between second and third carmalts

Front 21

Open castration
-indication

Back 21

Dog > 20 kg

Front 22

Open castration
-what needs to be separated once open

Back 22

-parietal tunic
-cremaster m.

Front 23

Open castration
-included in triple clamp technique

Back 23

-ductus deferens
-pampiniform plexus

Front 24

Open castration
-why is the transfixation ligature on the primary vaginal tunic necessary

Back 24

-needed to close the peritoneal cavity

Front 25

Dog Castration
-closure

Back 25

2 layer
-deep fascial layer (interrupted)
-skin apposition (subcuticular)

Front 26

Cat Castration
-technique

Back 26

-overhand hemostat

*points facing palm

Front 27

Cat castration
-scrotal healing

Back 27

-by second intention

Front 28

Cat castration
-"other" techniques

Back 28

-figure of eight hemostat technique
-square knot open technique
-suture or hemoclip attenuation

Front 29

Castration
-complication

Back 29

-scrotal hematoma
-abdominal hemorrhage
-incisional abnormalities
-Scrotal abscess
-urethral damage or ligation
-unwanted pregnancy

Front 30

Scrotal hematoma
-cause

Back 30

-hemorrhage from skin incision (skin & subcutaneous)

Front 31

Scrotal hematoma
-treatment

Back 31

Mild
-cold/warm compresses
-analgesia
-strict cage rest

Severe
-scrotal ablation

Front 32

Abdominal hemorrhage
-causes

Back 32

-ligature improper placement or knot tying

Front 33

Abdominal hemorrhage
-treatment

Back 33

-aggressive fluid therapy
-abdominal exploration to find pedicle

Front 34

Incisional abnormalities

Back 34

-swelling
-seroma
-cellulitis
-infection

Front 35

Incisional abnormalities
-treatment

Back 35

Medical
-analgesics
-compresses
-antibiotics

Protect with E-collar

Front 36

Scrotal abscess
-due to

Back 36

-suture reaction (braided, non-absorbable)
-poor technique
-contamination of open incisions (cat)

Front 37

Unwanted pregnancy
-how long can sperm persist

Back 37

-up to 5 days

Front 38

Scrotal surface Lesions
-due to

Back 38

-trauma
-ulcerative dermatitis
-immune mediated
-weather induced
-neoplasia
-older dog (scrotal hyperplasia, varicosities)
-Infection (bacterial, rickettsial)

Front 39

Scrotal Hyperplasia
-signs

Back 39

-pendulous
-pigmented
-cobblestone appearance

Front 40

Scrotal Enlargement
-causes

Back 40

-orchitis/epididymitis
-testicular torsion
-scrotal hernia
-sperm granuloma
-scrotal neoplasia

Front 41

Scrotal neoplasia
-primary neoplasias

Back 41

-Mass Cell Tumor
-Squamous Cell Carcinoma
-Melanoma
-Papilloma
-Fibroma
-Sarcoma

Front 42

Scrotal Neoplasia
-secondary neoplasia

Back 42

Primary tumors of testicle that invade scrotum (not common)
-sertoli cell tumor
-interstitial cell tumor

Front 43

Scrotal Ablation
-indications

Back 43

-scrotal mass
-scrotal trauma
-orchiectomy in aged animal ---> pendulous scrotum
-Scrotal hematoma, abscess
-Conjunction with scrotal urethrostomy

Front 44

Scrotal Ablation
-pre-surgical prep

Back 44

-scrotum
-prescrotal
-part of perineal region

Front 45

Scrotal Ablation
-where to make incision

Back 45

Pay attention to tension lines
-excessive skin removal impacts closure and degree of tension on closure
-neoplasia requires more extensive resection to obtain margins

Front 46

Scrotal Ablation
-skin incision

Back 46

-elliptical around base of scrotum
-in jct. of haired and non-haired region
-through fibrous connective tissue and transect median septum

Front 47

Scrotal ablation
-closure

Back 47

3 layer
-deep fascia: interrupted (careful of urethra)
-subcutaneous closure: interrupted or continuous
-skin: subcuticular

Front 48

Scrotal ablation
-complications

Back 48

Similar to castration
-seroma
-dehiscence
-incisional infection
-urethral damage

Front 49

Scrotal Ablation
Seroma
-due to

Back 49

-failure to eliminate dead space on closure

Front 50

Scrotal ablation
Dehiscence
-due to

Back 50

-excessive tension (removed too much skin)

Front 51

Scrotal ablation
incisional infection
-due to

Back 51

-self trauma
-poor aseptic technique

Front 52

Scrotal ablation
urethral damage
-due to

Back 52

-closure or procedure