Lecture13Notes - 13 CHIRURGIA ADDOMINALE Chirurgia...

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13- CHIRURGIA ADDOMIN ALE
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Chirurgia addominale Celiotomia : incisione ventrale mediana della cavità addominale Laparotomia : incisione su un fianco Scopo diagnostico (esplorativa ), per biopsie o terapeutico. Chirurgia d’urgenza nell’ addome acuto (torsione gastrica, perforazione intestinale, rottura parenchimi ecc.) Esami collaterali e visita accurata. Visita anestesiologica (ASA) Preparazione del paziente e del campo operatorio.
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Anatomia chirurgica parete addominale Linea alba: guaina del muscolo retto dell’addome – lamina esterna: aponeurosi mm. obliquo esterno e interno addome lamina interna: aponeurosi mm. obliquo int.,trasverso e fascia trasversa Lamina interna scompare nel terzo caudale dell’addome quindi più difficile da individuare Leg. falciforme
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Chirurgia addominale Tecnica chirurgica : Celiotomia preombelicale od addominale craniale (dal processo xifoideo dello sterno) per fegato, stomaco. Celiotomia postombelicale o addominale caudale per intestino, vescica. Celiotomia postombelicale e parapeniena nel cane maschio Celiotomia paracostale (poco usata) per reni e ghiandole surrenali.
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Posizionamento paziente: celiotomia
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Chirurgia addominale : Preparazione di un largo campo operatorio
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Chirurgia addominale Esplorare sistematicamente e delicatamente gli organi della cavità, proteggere le strutture dalla disidratazione, lavaggio copioso in caso di infezione generalizzata o di contaminazione, rimuovere i fluidi di lavaggio, assicurarsi di aver rimosso tutte le garze Chiudere parete addominale. Fasce e muscoli Punti staccati Filo assorbibile Sottocute Sutura continua – filo assorbibile Cute – punti staccati semplici Sutura intradermica – sutura incatenata
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Nel cane maschio: L’incisione cutanea viene prolungata lateralmente al prepuzio Branche V .Pudenda esterna m. prepuziale
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