TECHNIQUE

Oesophageal Surgery of Waterfowl (Disease Investigation & Control - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Control / Treatment & Care / Techniques:
Synonyms and Keywords --
Description 1) Hook removal: The following description outlines the procedure as described by Waine (B11.34.w2), Robinson, Routh & Sanderson (B37.x.w1), Goulden (P8.3.w1):
  • Anaesthetise (General anaesthesia) .
  • Place bird in lateral recumbency.
  • Incise skin on the left side of the neck. [Incision on the left side of the neck is recommended, as the jugular vain is considerably more developed on the right side (J3.120.w1, B14).] (Incision site may first be clamped with artery forceps to decrease bleeding P8.3.w1).
  • Remove hook.
  • Carefully debride and remove necrotic tissue (B37.x.w1). N.B. pus in swans is very thick and surgical debridement may damage healthy tissue; chemical debridement postoperatively using e.g. set honey is an alternative (P8.3.w1).
  • Suture oesophagus in two layers using an atraumatic needle and suaged-on suture material such as absorbable monofilament (e.g. Monocryl, Ethicon) and ensuring an inverting pattern is used on the outer layer. 
  • If the site is infected, the skin should be left unsutured or partially sutured, to allow drainage, and managed as an open wound (P8.3.w1).
  • Give post-operative antibiotics
  • Careful gavage (stomach tube) feeding may be required for the first three days postoperatively (B37.x.w1).

(B11.34.w2, B37.x.w1, P8.3.w1)

2) Removal of impacted food (e.g. secondary to lead poisoning): The following description outlines the procedure as described by Cooke in treating an adult Whooper swan Cygnus cygnus (J3.111.w2).

  • Prepare surgical site - clip feathers from skin over most dependent part of distended area, clean with chlorhexidine (Hibiscrub, ICI) and paint with povidone iodine.
  • Instil 1% lignocaine (0.25ml) to provide cutaneous anaesthesia.
  • Incise skin, three inch (7.6cm) incision, exposing the oesophagus.
  • Incise along oesophagus, 2.5 inches (6.35cm) incision.
  • Ligate small superficial vessels with 2/0 catgut as required.
  • Gently pull material from distal oesophagus and proventriculus using e.g. nine-inch artery forceps.
  • Gently 'milk' material in upper oesophagus down towards incision in small amounts and remove.
  • N.B. use extreme care to avoid grasping oesophageal or proventricular mucosa
  • Endoscopy is useful in visualisation.
  • Close oesophagus in two layers with 2/0 Dexon (Cynamid) on an atraumatic needle: first layer accurate apposition of mucosa, sutured in in a continuous Czerney suture, second layer inverting Lembert sutures.
  • Flush subcutaneous tissues with sterile saline and dust with sodium benzyl penicillin (Crystapen, Glaxovet).
  • Close skin with simple interrupted sutures, using Dexon.
  • Give antibiotic cover .

(J3.111.w2).

Appropriate Use (?)
  • Treatment of some types of Foreign Body Ingestion,
  • Surgical removal of a hook is appropriate if the hook is deeply embedded in the oesophageal wall or there is a sizeable tear in the oesophagus (B37.x.w1).
Notes Incision on the left side of the neck is recommended, as the jugular vain is considerably more developed on the right side (J3.120.w1, B14).

Opinions differ as to whether either or both of these procedures may be carried out under local anaesthetic or whether general anaesthetic should be employed. Suggestions include:

  • Removal of hook: local anaesthetic (B11.34.w2), general anaesthetic (P8.3.w1).
  • Removal of impacted material: local anaesthetic (J3.111.w2), general anaesthetic (B11.34.w2).
Complications/ Limitations / Risk Care should be taken to avoid excessively reducing the diameter of the oesophagus while placing the inverting suture. This is less likely to be a problem when the oesophagus has been stretched by impacted material (J3.111.w2).
Equipment / Chemicals required and Suppliers Equipment and consumables for general anaesthesia and surgery, including surgical instruments and consumables suitable for the size of the bird.
Expertise level / Ease of Use Procedure should only be undertaken by an individual with appropriate clinical training and practical experience; this would usually be a veterinarian.
Cost/ Availability May be quite expensive: cost of general anaesthesia and surgical operation.
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
Referee  
References J3.111.w2, J3.120.w1, B11.34.w2, B14, B37.x.w1, P8.3.w1)

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