TECHNIQUE

Pyelolithotomy in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description This description is based on that given by Jenkins (2004) (B602.22.w22).
Preparation
  • Anaesthetise the rabbit.
  • Shave from pubis to midthorax.
  • Place the rabbit in dorsal recumbency.
  • Prepare the rabbit for aseptic surgery.
Initial 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. 
  • 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 abdomen. (V.w122)
Pyelolithotomy
  • Dissect the kidney free of its peritoneal attachments.
  • Rotate the kidney medially to expose the renal pelvis and proximal ureter.
  • Incise over the pelvis and proximal ureter.
  • Remove the 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 uteter into the bladder, checking that the ureter is patent.
  • Close the incision in a simple continuous pattern using 5-0 or 6-0 (1 or 0.7 metric) absorbable suture material.
  • Lavage the abdomen.
Closing the abdomen
  • Gently replace the small intestines, colon and caecum into the abdomen.
  • Close the abdomen in a routine manner. See: Laparotomy in Rabbits

(B602.22.w22)

Appropriate Use (?)
  • For removal of renal calculi which have caused distension of the proximal ureter and renal pelvis. (B602.22.w22) 
    • 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)
  • This approach is advantageous compared to Nephrotomy in Rabbits because: (B602.22.w22)
    • No occlusion of the renal vasculature is needed. (B602.22.w22)
    • Trauma to the renal parenchyma is avoided, therefore deleterious effects on renal function are minimised. (B602.22.w22)
Notes --
Complications/ Limitations / Risk
  • Not appropriate when significant damage to the renal parenchyma and reduction in kidney function has occurred. (B602.22.w22)
  • There is a risk of post-surgical tissue adhesions, particularly if the intestines have been removed from the abdomen rather than retracted. (V.w122)
Equipment / Chemicals required and Suppliers
  • Standard anaesthetic equipment for rabbits.

  • Surgical equipment appropriate for rabbits.

  • Suture materials.

Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience, usually an experienced veterinarian.
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 Aidan Raftery MVB CertZooMed CBiol MIBiol MRCVS (V.w122)
References B602.18.w18, B602.22.w22, J15.30.w1, V.w122

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