TECHNIQUE

Ventriculostomy and Proventriculostomy (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords  
Description Ventriculostomy has been used to remove metal objects from the gizzard of cranes. (J4.173.w6)
  • Pre-operative fasting may be used to reduce food in the gizzard.
    • Fast for 24 hours prior to surgery. (B12.56.w14)
  • Pre-operative antibiotics (gentamicin sulphate 30 mg).
  • Anaesthetise.
  • Place on a drip (lactated Ringer's solution) for circulatory support.
    • A bolus of 5.0 mL 50% dextrose was given intravenously as a bolus before and after the comppletion of surgery, to reduce risks of hypoglycaemia associated with pre-operative fasting.
  • Place in right lateral recumbency.
  • Make a skin incision parallel to and posterior to the last rib.
  • Separate the abdominal muscles along the direction of their fibres to expose the peritoneum.
  • Incise through into the body cavity
  • Exteriorise the gizzard using two stay sutures through the muscular walls.
  • Pack the gizzard off from the body cavity using sterile gauze moistened with sterile saline solution.
  • Incise through the muscularis intermedii at the posterior end of the gizzard.
    • OR incise through the proventriculus (which is less muscular). (B115.8.w4)
  • Remove the foreign objects.
  • Close the gizzard in a three-layer closure with 4-0 absorbable suture material, using simple interrupted sutures in the mucosa and submucosa (incorporating part of the muscle layer since the submucosa is very thin) and close the muscular layer with both horizontal and vertical mattress sutures.
  • Place sutures in an interlocking continuous pattern in the adventitia.
  • Close the air sac using 4-0 absorbable suture material. (B12.56.w14)
  • Close the abdominal muscles using 3-0 or 4-0 absorbable suture material and simple interrupted sutures.
  • Close the skin using 3-0 or 4-0 absorbable (B115.8.w4) or non-absorbable (B12.56.w14) suture material and simple interrupted sutures.
  • Give antibiotics and fluids.
  • Feed a reduced quantity of food for five days post surgery.

(B12.56.w14, B115.8.w4, J4.173.w6)

Appropriate Use (?)
  • For removal of foreign objects from the gizzard, particularly when they are causing or are thought likely to cause injury to the bird. (J4.173.w6)
Notes
  • Faeces should return to normal within 10 days of surgery. (B115.8.w4, J4.173.w6)
Complications/ Limitations / Risk
  • This is highly invasive surgery with a long recovery time. (P87.8.w6)
  • Scar tissue and adhesions may form at the surgery site. (J4.173.w6)
  • Incisions made through the tendinous aponeurosis rather than through the muscle are more likely to rupture, with resultant peritonitis; this approac is therefore not recommended. (J4.173.w6)
  • Birds can ingest further objects after surgery. (J4.173.w6)
Equipment / Chemicals required and Suppliers
  • Standard anaesthetic equipment

  • Surgical equipment.

  • Suture materials.

  • Supportive care - fluids, intravenous drip, antibiotics.

Expertise level / Ease of Use This is a veterinary procedure. This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost/ Availability

The costs of a surgical operation include those associated with: (J15.30.w1)

  • Pre-operative diagnostics (e.g. radiography, ultrasonography, blood tests)
  • Anaesthesia.
  • Perioperative medication (e.g. analgesics, antibiotics, fluids).
  • Surgical preparation (of the operating theatre and the patient, including staff time).
  • Consumables and equipment.
  • Time of the surgeon and assistant(s).
  • Post-operative hospitalisation.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee  
References J4.173.w6

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