VSR 421: Regional Veterinary Surgery (2+1)

RUMENOTOMY

Treatment

• Rumentomy is indicated to remove foreign bodies from the reticulum.

Site

• Rumenotomy is done through an incision in the left flank and the site of incision is equidistant from this tuber coxae and last rib beginning 5cm ventral to the lumbar transverse process, due to the voluminous abdomen and incision parallel to the last rib is preferred to provide an easy access to the reticulum.

Preparation of site

• The whole dorsum and the left abdominal wall of the animal should be thoroughly cleaned with soap and water to remove all loose hairs, dirt and dust.
• The left flank is shaved cleaned and the area should be scrubbed with antiseptic lotions like povidone iodine scrub or chlorhexidine. After drying the area with sterile mops, Povidone iodine should be painted.

Anaesthesia

•  Paravertebral nerve block is sufficient for rumenotomy and difficult cattle or buffaloes may be given mild sedation for restraint.

Paravertebral nerve block

• Following painting the site with antiseptics the area should be covered with sterile draper, exposing the surgical site alone.

Application of antiseptic	Draping the surgical site

• Surgical procedure
• The laparotomy incision should be long enough to allow the surgeon’s arm inside the abdomen and the abdomen is opened through a standing laparotomy procedure. If the rumen is not full, the ruminal walls and abdominal cavity are explored thoroughly to examine, the diaphragm, outer wall of reticulum, spleen and liver for pathological lesions.

Rumenotomy - Incision	Fixing the weingarth rumenotomy frame	Rumenotomy frame in position

• The ruminal wall is brought to the laparotomy incision and fixed to it using a Weingarth’s rumenotomy frame or using a row of stay structures. The tense and exposed ruminal wall is incised and the cut edges of the rumen wall is everted and fixed to the skin edges.
• After partial evacuation of the contents of the rumen, the ruminal floor and reticulum were explored with the hand to locate foreign bodies.

Churned ruminal content  in case of DH	Diphragmetic vent	Completed herniorrhaphy

• The sharp penetrating foreign bodies should be removed gently and small metallic materials may be retrieved by using a  magnet inserted into the reticulum.
• Before closure of the rumen, rumen P^H should be corrected and transplantation also may be done in case of disturbed rumen microflora.
• The rumen wound edges should be thoroughly cleaned and the surgeon must rescrub before suturing the wound. The rumen is sutured with Cushing’s followed by Lemberts’ suture pattern using No 1 or 2 chromic catgut. All soiled instruments should be discarded and fresh set of instruments should be used for closure of the lapartomy wound.
• Postoperative care includes  dressing of the cutaneous wound, A course of antibiotics should be given for 5 to 7 days and the sutures are removed by 10^th postoperative day. Any failure in asepsis during surgery might produce a discharging sinus at the operative site.