Public setting for Slideshare testing of Powerpoint conversion

1. RTO 3044
Coordinate and perform
theatre routines
ACMVET408a

2. RTO 3044
Session 1
1. Introduction to surgery
2. Theatre Practice

3. RTO 3044
What is surgery?
• The treatment of diseases, injuries and
deformities by manual or operative
methods.
• Operation – any action performed with
instruments or by the hands or a surgeon:
a surgical procedure.

4. RTO 3044
How is Surgery Performed?
1.
2.
3.

5. RTO 3044
How is Surgery Performed?
1. Usually under anaesthesia

6. RTO 3044
How is Surgery Performed?
2. With surgical instruments

7. RTO 3044
How is Surgery Performed?
3. Often in an
operating theatre

8. RTO 3044
Terminology Associated with
Surgery
1. Prefixes
• Describe the area involved
– Lapar- abdomen
– Thorac- chest
– Cyst- bladder
– Arthro- joint

9. RTO 3044
Terminology Associated with
Surgery
2. Suffixes
• Describe the procedure being performed
• Examples:
– “-ectomy” – excision, surgical removal
– “-otomy” – to open up and have a look
– “-oscopy” – to view
– “-ostomy” – general term for an operation in which
an artificial opening is formed eg. colostomy

10. RTO 3044
Terminology Associated with
Surgery
• What do the following terms mean?
– Laparotomy
– Arthroscopy
– Cystotomy
– Thoracotomy
– Lumpectomy

11. RTO 3044
1.Time considerations
• Elective –can be done anytime
• Non-Elective –These are non-anticipated
situations that arise requiring surgery
• Emergency –These are unexpected
events that require surgery on short notice
Classifying Surgeries

12. RTO 3044
Classifying Surgeries
2. Degree of Contamination
This system of classification is useful for a
number of reasons that include:
a) Where the surgery is performed
b) Order of performance of surgeries
c) Variation in attempts at asepsis
d) Use of antibiotics

13. RTO 3044
Clean Surgery
• Gastrointestinal, urinary or respiratory
tracts are not entered
• No inflammation noted at time
of surgery

14. RTO 3044
Clean-Contaminated Surgery
• Gastrointestinal, urinary or respiratory
tracts are entered but there is no
significant spillage of contents

15. RTO 3044
Contaminated-Dirty Surgery
• Gross spillage of contaminated contents
occurs
• Acute inflammation is present

16. RTO 3044

17. RTO 3044
Basic Principles of Surgery
• First, do no harm
• Surgeon's skill
• Asepsis
• Comfort of surgeon and animal
• Tissue handling
• Tissue dissection
• Correct choice and placement of suture material
• Short operating time

18. RTO 3044
Comfort of Surgeon
• Adequate preparation
for type of surgery
• Clothing
• Lighting
• Environmental
temperature
• Preparation of
personnel and
equipment

19. RTO 3044
Comfort of Animal
• Adequate padding
• Provision for fluid
drainage from the
surgery table
• Consideration of body
temperature

20. RTO 3044
Theatre Practice.
• Organisation of the theatre environment
will depend on the specific veterinary
clinic.
• What sort of practice do you come from?

21. RTO 3044

22. RTO 3044
Theatre Practice.
Ideally, there is a designated surgery nurse
and additionally a float nurse that is
available for assistance. Neither of these
people should be expected to assist with
reception duties.

23. RTO 3044
Duties of the Surgical Nurse.
Include:
• Patient admission
• Patient pre-operative examination
• Preparation of the theatre/preparation area
• Patient preparation
• Hospital patient care
• Theatre schedule
• Anaesthetic assistance

24. RTO 3044
Duties of the Surgical Nurse.
• Surgical preparation
• Surgical assistance
• Pathology preparation
• Patient records
• Discharge information

25. RTO 3044
Duties of the Surgical Nurse.
• Equipment cleaning and sterilisation
• Cleaning surgery
• Restocking equipment

26. RTO 3044
Duties of the Float Nurse.
The Float Nurse may be involved in many of the
above activities, but especially:
• helping with theatre/preparation area
• assistance with patient admission/preparation
• patient surgical preparation
• surgery assistance (tie surgical teams etc)
• organise equipment use
• assist with anaesthesia
• cleaning up

27. RTO 3044
Duties of the Float Nurse.
How well the surgical nurse and circulating
or float nurse work together will affect the
entire surgical operation for the day.

28. RTO 3044
Patient History
The surgical nurse must ensure that adequate and
accurate histories are complied for all surgical
patients.
Information must include:
• Previous and current health conditions
• Current medications
• Any previous reactions to drugs or anaesthetics

29. RTO 3044
Patient History
All this information needs to be readily
available to the veterinarian prior to surgery
as it impacts on which drugs or anaesthetic
regimes are used, and indeed if surgery will
proceed at all

30. RTO 3044
Theatre Preparation
The surgical nurse should always walk into a clean
surgery area. On arrival, all surfaces should be
wiped down again in preparation for the day. The
surgical table and surgical instrument trolley will
need to be disinfected again just prior to surgery.
The surgery room itself should be cool and dry (on
hot days it is beneficial to start the air conditioning
as soon as is feasible to ensure a cool operating
environment and contamination minimisation).

31. RTO 3044
Theatre Preparation
• Cages set up
• Stock supplies
• Paperwork: ensure estimates are performed the
day prior
• Admission forms filled out
• Physical examination (record)
• IVF set up

32. RTO 3044
Theatre Preparation
Other equipment eg. cruciate, exlap kit, laparoscopy
(have lists), vaccinations, microchip …
Automatic processor
Kits, gloves, towels, scrubbing brush ready
Premedication, induction agents, abis, nsaids
Tattoo equipment clean and ready
ET tubes ready with cuffs checked

33. RTO 3044
Surgical Terminology
Before setting up for surgery, it is important to understand
what the surgery involves. Appropriate terminology should
be used as much as possible.
Gastrotomy - a incision into the stomach
Gastroscopy - a inspection of the interior of the stomach
with gastroscope
Enterotomy - a incision into the intestine
Intestinal intussusception –prolapse of one part of the
intestine into the lumen of an immediately adjacent part
causing intestinal obstruction.
Cystotomy - a incision into the bladder

34. RTO 3044
COMPLETE THE QUESTIONS
AND ACTIVITIES IN YOUR
LEARNER GUIDE

35. RTO 3044
Examples of specific
surgical conditions:

36. RTO 3044
1. Ophthalmic conditions
(a) Ectropion
Ectropion is the eversion of the eyelid margins

37. RTO 3044
b) Entropian
Entropion is inversion of the eyelid margins.

38. RTO 3044
c) Distichiasis
Distichia refers to having "double eye lashes", where
some eyelashes are often pointing inwards and irritating
the cornea.
Click here for more information about Distichiasis

39. RTO 3044
d) Follicular ophthalmitis
“Cherry eye" (or follicular ophthalmitis) is a
condition of the nictitating membrane (third eyelid)
when it everts because of hypertrophy and
prolapse of the gland within the third eyelid. Mild
cases may resolve with medical therapy but often
recur. Recurrent or more severe case should be
treated surgically. This is more prevalent in small
breeds of dogs

40. RTO 3044

41. RTO 3044
Otic or Aural conditions
Aural haematoma
Usually a condition induced by an underlying ear infection
causing the pet to shake their head or scratch at the ear
resulting in the rupture of a blood vessel in the pinna (ear
flap).
These can resolve spontaneously, however complications
may occur but will usually leave a fibrosed and somewhat
deformed ear

42. RTO 3044
Otic or Aural conditions

43. RTO 3044
c) Pinnectomy uni/bilateral
Most common due to squamous cell
carcinoma in white cats

44. RTO 3044
Intussusception
Click here for information
concerning Intussusception

45. RTO 3044
Brachycephalic airway syndrome
• narrowed nares
• stenotic nares
• elongated soft palate
• extra pharyngeal mucosa
• everted laryngeal saccules
• laryngeal collapse
• collapsing (hypoplastic) trachea

46. RTO 3044

47. RTO 3044
Pyometra
The pyometreic uterus of a dog just after surgery.
This picture was taken just minutes after emergency surgery.
The dog that it was removed from survived.

48. RTO 3044
Biopsy
• Needle core

49. RTO 3044
Biopsy
• Punch biopsy
• Trephine
Click here for biopsy punch sizes
Click here for biopsy techniques

50. RTO 3044

51. RTO 3044