Plus-Hex CLINICAL suture material , such as polyglactin 910 . The excess omentum can then be resected , using an emasculator for haemostasis , and discarded ( Figure 5 ). Localised areas of traumatised serosa , which are at high risk of adhesion formation post-surgery , can be treated using a bioresorbable hyaluronate-CMC membrane , such as Seprafilm [ 16 ] . The film is applied to the serosa and forms a protective gel barrier , minimising friction for up to 7 days postoperatively [ 16 ] .
Figure 6 . Small colon prepared for enterotomy for treatment of enterolithiasis . Note the use of an impervious drape to protect the sterile field and stay sutures to stabilise the intestine prior to enterotomy .
Figure 5 . Resection of omentum following ligation using an emasculator for haemostasis , to minimise postoperative adhesion formation .
Enterotomy
An enterotomy can be performed at any site along the intestines [ 12 ] . A pelvic flexure enterotomy is a commonly performed procedure in cases with abnormalities of the large colon , to evacuate the contents of the colon or to remove a foreign body [ 18 ] . In cases of enterolith or foreign body removal , an enterotomy can be performed in another area of the colon if the mass cannot be moved to the pelvic flexure [ 12 ] ( Figure 6 ).
A colon tray is a stainless steel tray which can be tilted as needed and is required for many surgical colic cases , either to allow more space for the VS to investigate the abdomen by exteriorising the colon , or to carry out a pelvic flexure enterotomy [ 11 ] . Some surgical tables have an attachable colon tray and others can be manoeuvred independently into position [ 7 ] . Placing the colon tray between the horse ' s hind legs , as opposed to placing it at the side of the abdomen , reduces crowding and lowers the risk of contaminating the surgical field [ 7 ] ( Figure 1 , page 26 ). The colon tray is to be positioned so it slopes towards the collection bucket and will be covered using non-abrasive impervious drapes [ 7 ] . The large colon will be exteriorised and placed on the colon tray [ 18 ] ( Figure 7 ).
Figure 7 . Preparation of the large colon for pelvic flexure enterotomy , on a colon tray placed between the hind limbs .
A second protective impervious drape is placed on top of the colon , then secured to the laparotomy drape , to create a barrier between the enterotomy site and the sterile surgical field [ 12 ] ( Figure 6 ). Two warm water ( 36 ° C ) hose pipes , facilitated by two taps or a Y-junction connector , are required for the enterotomy [ 18 ] . The VN will insert one hose through the enterotomy , guided by a sterile assistant , and evacuate the contents of both the ventral and dorsal colon , using high-volume lavage [ 18 ] . The other hose is used continuously to keep the serosal surface of the colon clean from faecal contamination during evacuation [ 18 ] .
Volume 38 ( 3 ) • June 2023
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