The flank approach to the uterus??

RE: The flank approach to the uterus??

Anthony Dennison — Fri, 17 Sep 2021 16:18:21 GMT

[quote userid="9179" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29972/the-flank-approach-to-the-uterus/232710#232710"]Flank approach to bitches was/is very popular in South Africa - supposedly faster, but the strain and difficulty visualising the right pedicle always made me very nervous. I only do flank spays in cats for this reason. I think c-section and pyo in dogs very difficult via flank, especially if they bleed.[/quote]

Interesting. We have a South African vet who constantly quips about doing flank cat spays and always wants to do them midline

RE: The flank approach to the uterus??

Andreas Ege — Fri, 10 Sep 2021 12:07:18 GMT

[quote userid="3094" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29972/the-flank-approach-to-the-uterus/232969#232969"]i have never done a right-flank nor a moidline laparotomy in a ruminant, has anyone else?? [/quote]

I have both, right-flank for displaced abomasum, as far as I am aware the standard approach. I've seen one cow caesar on right, already had 3 or 4 on the left.

Done a couple of midlines in calves to repair herniation.

Doing a cat flank frequently still takes me considerably longer than midline even after more than a decade in GB. Only do flank if absolutely no choice. ;-)

RE: The flank approach to the uterus??

Julian Earl — Fri, 10 Sep 2021 07:55:51 GMT

[quote userid="11901" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29972/the-flank-approach-to-the-uterus/232770#232770"]Nobody seems to know where the “left sided flank spay” trend originated but it seems to have stuck. [/quote]

Could it have originated with flank laparotomies in ruminants? In these we have to use the left-sided approach to have the rumen stop the intestines falling out on he floor eg during a caesarean? It might have just followed from this in sheep and cattle?

i have never done a right-flank nor a moidline laparotomy in a ruminant, has anyone else??

RE: The flank approach to the uterus??

Miriam Lodewyks — Wed, 01 Sep 2021 18:09:38 GMT

Funny enough I was discussing this with one of the surgeons at the University of Ghent (Belgium). He lectures globally on lap-spaying and says the UK is unique in this regard. Nobody seems to know where the “left sided flank spay” trend originated but it seems to have stuck.
I’m happy doing either midline or left flank for cats, midline only for dogs.
After 20 years of campaigning the UK does finally seem to be accepting the fact that if you remove just the ovaries the uterus becomes atrophied and “dormant”.

RE: The flank approach to the uterus??

Allison Gleadhill — Tue, 31 Aug 2021 12:53:26 GMT

I spay bitches flank & do right flank for bitches due to the right ovary being right far forwards. Usually an ovariectomy. Easy esp in juvenile cockerpoos where it’s just like a marginally scaled up cat spay but ok in bigger fatter bitches. Ex boss insisted I did it & after about 3 bitches I was a convert.

RE: The flank approach to the uterus??

Clive Ansell — Mon, 30 Aug 2021 19:35:24 GMT

[quote userid="12930" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29972/the-flank-approach-to-the-uterus/232713#232713"]what is the anatomic reason for it always being a left flank spay (when the right ovary is the tighter one) - what is it that gets in the way and prevents a right flank approach in a cat (or dog for that matter)?[/quote]

Most of us are right handed, and so it would be trickier, albeit possible via right flank.

RE: The flank approach to the uterus??

Beats — Mon, 30 Aug 2021 19:18:20 GMT

stupid question, but while on the topic of flank spays... what is the anatomic reason for it always being a left flank spay (when the right ovary is the tighter one) - what is it that gets in the way and prevents a right flank approach in a cat (or dog for that matter)?

RE: The flank approach to the uterus??

Chris Milligan — Mon, 30 Aug 2021 18:14:39 GMT

Flank approach to bitches was/is very popular in South Africa - supposedly faster, but the strain and difficulty visualising the right pedicle always made me very nervous. I only do flank spays in cats for this reason. I think c-section and pyo in dogs very difficult via flank, especially if they bleed.