Hauptman retractor

Re: Hauptman retractor

Ben Walton — Wed, 20 Jul 2011 12:32:00 GMT

For what it's worth, here's another tip for breaking down the ovarian ligament...

The ligament gets denser and stronger distally (nearer to the ovary), and also gets closer to the ovarian vessels. Therefore it is tougher to snap, and more likely to propagate a tear through the vessels, if you do it close to the ovary. Proximally (near to the kidney), it is wider, thinner, and further away from the vessels. So tension the ligament with gentle traction on the ovary with one hand, get your other hand in deep and snap the ligament with finger-click type motion.

Hope that helps?!

Re: Hauptman retractor

Vikki Halliday LLB — Tue, 19 Jul 2011 08:51:35 GMT

I detested deep chested fat bitch spays until a colleague taught me to tilt the table cranially during surgery, (obviously making sure the hind legs were tied to the caudal end of the table first, can be rather embarasssing when the bitch starts to head towards the anaesthetic machine!).

It doesn't need much, 10-15 degrees drop at the cranial end will help in using gravity to give you a better view as the stomach and liver are displaced cranially, and it shouldn't compromise respiratory function at all if you keep the tilt gentle.

Another "toy" I have grown to love is my Lonestar retractor system, much more useful than any other retractor I have used, and a fair bit cheaper too.

http://www.arksurgical.co.uk/products/sterile_retractor_rings

Ark surgical import them, they were designed to be single use and for the human market, however they can be re-sterilised. I've found them useful for large dogs where the abdominal musculature is so tight you are fighting against it and the ovarian ligament at the same time. I agree that nothing beats properly breaking down that ligament though, and artery forceps do come in handy for it if you are not brave enough for scissors.

Re: Hauptman retractor

David Mills — Tue, 19 Jul 2011 00:57:07 GMT

I have used one, and they can be useful in deep, fat, things, but they are no magician's wand- far better is a nurse with a pair of gloves on to get the confidence up.

As those above have intimated, it's about finding a technique that suits you best and practising it. I've worked with over 50 other vets in my time and none of us have done it in the same way. I use only one clamp per pedicle, and catgut, for instance, and a scalpel blade to cut the ligament - people out there will gasp at some of those things. Fortune favours the brave - if anything, with bitch spays I've found it's when things go wrong (e.g. suture slips off when stump released) that you learn the most, and, worst case scenario, you get a nice view of the kidney and one isolated vessel to tie off.

Re: Hauptman retractor

Niall Taylor — Tue, 05 Jul 2011 07:45:54 GMT

I would agree with Michael. If you are lacking in confidence with bitch spays a fancy bit of kit isn't going to help address that or make things any easier.

It comes down to practice and (hopefully) having a supportive senior team so that you can work supervised until you've got a few more cases under your belt. Spaying a bitch is a tricky procedure no matter what anyone says and everyone sweated them and had problems at various stages but you've had the same training as the rest of us and there are thousands of vets out there doing them every day. There is no reason at all that you can't be the same - if I can do them then so can you! There's nothing magic about it, it's just practice and persistence, no tricks, just finding a technique that suits you and sticking with it. It get's easier, no question.

Cheers,

Niall

Re: Hauptman retractor

Michael Woodhouse — Mon, 04 Jul 2011 23:49:23 GMT

May I ask you a question without seeming rude? Are you a new grad?

You shouldn't 'need' one of these to spay a bitch. I have never used one, but bitch spays get easier with practice and make sure you break the ligament down properly. Some bitches it is really tough and I either saw through it using a pair of artery forceps or even use a pair of scissors to cut it. Once you have broken it down completely you will have the space you crave. When I started I used to stretch things a bit and chicken out and fight with an ovary wanting to disappear back into the abdomen!

I can see that in a really fat Labrador there may be a use. If you get one and use it you will come to rely on it and not be able to spay a bitch without it. That would be my fear.

Re: Hauptman retractor

Mark Hedberg — Mon, 04 Jul 2011 23:43:31 GMT

Stitch the suture into the stump, won't slip off then. Also use angiotribes, much better crushing effect. Also a second loop around the stump if you're especially paranoid.

And cut the stump above the clamp; the compressed area is free hemostasis. :)