‘The Secret of Gastrointestinal Surgery’
Presenter – Laurent Findji – Director DVM, MS, Dipl ECVS, MRCVS, European Specialist in Small Animal Surgery, consultant surgeon at VRCC Referral Centre, Laindon, Essex
Laurent Findji had me completely gripped by offering to share his ‘secret of surgery’ when discussing the essentials of gastrointestinal surgery at last Thursday’s webinar. As surgery has never been my forte, I was open to any ‘secret’ that could help improve my aptitude towards this essential skill.
As it happened, the Secret to Surgery really wasn’t a ‘mind blowing’ concept, but something very basic that could make all the difference. The gentle handling of tissues and attempting to be as atraumatic a surgeon as possible, was the secret offered by Mr Findji, and this of course translates across all surgery including gastrointestinal.
Always understanding the reason behind the decisions we make during gastrointestinal surgery was another pearl of wisdom offered by Mr Findji and he went on to quote a famous rock star “he who knows how will always work for he who knows why” (I’ll let you try and find out who the rock star is!).
This webinar did, of course, offer a lot more than ‘secrets’ and ‘proverbs’, although it was a great basis from which to start this lecture and to perform surgery. Some of the most important aspects of gastrointestinal surgery were discussed from the use of antibiotics to the application of various techniques.
Mr Findji was keen to stress that we should always use antibiotics with care. If uncomplicated, gastrointestinal surgery should be clean surgery and antibiotics should not be necessary. However, if there is an underlying on-going infection, or there has been significant contamination, antibiotics should be used. The choice of antibiotics should be based on treating both aerobes and anaerobes and second generation cepalosporins or a combination of amoxycillin, clavulinic acid and metronidazle would be appropriate.
Mr Findji also offered some great tips on the surgical management of linear foreign bodies, many a vet’s greatest fear. Avoiding multiple enterotomy sites offers the least traumatic technique and should increase the chances of success. By making one enterotomy incision at the oral end of the affected intestines, the linear foreign body can then be attached to a long catheter. This is then introduced into the enterotomy site and milked along all the affected portion of the intestine. Once milked through, an incision can be made at the distal end to remove the catheter and attached foreign body, making only two incisions necessary. If you are really lucky, it may be possible to milk the catheter right through into the colon where it can then be removed per rectum
There were a number of little gems offered by Mr Findji, with some great explanatory images, and I would highly recommend checking out his webinar and if you are lucky a few more secrets may also crop up along the way.
The Stethoscope (MRCVS)
If you missed the webinar it is now available to purchase at the link below