& Management / Disease
Investigation & Management / Techniques:
||This description is based on
that given by Jenkins (2004) (B602.22.w22).
- Note: renal function should be checked thoroughly before
this surgery is attempted. (B602.22.w22)
- Anaesthetise the rabbit. See: Treatment and Care
- Anaesthesia and Chemical Restrait
- Shave from pubis to midthorax.
- Place the rabbit in dorsal recumbency.
- Prepare the rabbit for aseptic surgery.
- Make a midline incision sufficiently long for abdominal exploration.
See: Laparotomy in Rabbits
- Drape saline-moistened laparotomy pads along the incision.
- Place a Balfour retractor to provide better visibility.
- A Lonestar Veterinary Retractor can be used to provide increased exposure to the abdomen. (B601.17.w17)
- Check for additional lesions in the abdomen.
- Gently remove the caecum, colon and small intestines from the
abdomen to facilitate kidney exposure; wrap these in moistened gauze.
- OR preferably retract the intestines to provide
access. This is more difficult to achieve but gives a lower risk of
post-operative adhesions than if the intestines are removed from the
- Dissect the kidney free of its peritoneal attachments.
- Rotate the kidney medially to expose the renal pelvis and proximal
- Using appropriate-size serrefines or vascular clamps to temporarily
occlude the renal vasculature.
- Divide the kidney along the sagittal plane.
- Remove renal calculi.
- Use saline to flush the renal pelvis and calyces to remove any
remaining small calculi.
- Pass a 3.5- to 5- French catheter through the ureter into the
bladder, checking that the ureter is patent.
- Press the halves of the kidney together and hold for several seconds
so the cut surfaces stick together.
- Suture the kidney capsule with simple interrupted sutures using 4-0
to 6-0 (1.5 - 0.7 metric) suture material.
- Place a suture every 2 - 4 mm.
- Remove the vascular clamps.
- Check the kidney for bleeding.
- If minor bleeding occurs, cover the incision site with absorbable
gelatin sponges (Gelfoam, Pharmacia & Upjohn) to control this.
Closing the abdomen
- Gently replace the small intestines, colon and caecum into the
- Close the abdomen in a routine manner. See: Laparotomy in Rabbits
|Appropriate Use (?)
- For removal of a calculus in the renal pelvis, if kidney
function is thought to be adequate and only minimal damage has
occurred to the renal parenchyma. (B602.18.w18)
- NOTE: Pyelolithotomy in Rabbits
is preferred. (B602.22.w22)
- Renal function should be checked thoroughly before this surgery
is attempted. (B602.22.w22)
|Complications/ Limitations / Risk
- Not appropriate when significant damage to the renal parenchyma and
reduction in kidney function has occurred. (B602.22.w22)
- Complications may occur including post-operative renal failure. (B602.22.w22)
- There is a risk of post-surgical tissue adhesions, particularly if
the intestines have been removed from the abdomen rather than
|Equipment / Chemicals required and Suppliers
|Expertise level / Ease of Use
- This procedure should only be
carried out by an individual with appropriate clinical training and practical
The costs of a surgical operation include those associated with: (J15.30.w1)
- Pre-operative diagnostics (e.g. radiography, ultrasonography, blood
- 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).
||Debra Bourne MA VetMB PhD
||Aidan Raftery MVB CertZooMed CBiol MIBiol MRCVS