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Lengthy Incisions

Wow! What a week! I was on vacation last week, and there has been a lot of changes with flights due to COVID-19, so I’m lucky that I managed to get home... or unlucky? Because I could have been in sunny Cali?? Either way, this week seemed busier than usual. We had a few patients in hospital for various procedures. The other associate and I agreed to have one week of opening shifts and one week of closing shifts, in the hopes of making it a bit more consistent for us, mainly for sleep. With the time change, and the time zone jump, it took a few days for my brain to settle. So now, it’s Sunday morning, my husband is snoring, and I have some time to blog!

Today, I wanted to talk about this unexplainable goal for new graduates to make smaller spay incisions. In school, I was taught to make bigger incisions than when I started with. You should always be able to see what you are tying off. You want to be able to see the blood vessels of the pedicles, and ensure you are not ligating something that should not be ligated.

As a fairly new grad, I can’t help but compare the length of my incision for my spay procedures with the seasoned vet at our practice. But I like to be able to see everything, visualize my gutters and pedicles (if I can through the fat). My spay incisions are about a hand’s width.

On Thursday, I had a medium to large dog spay. I was complaining to the RVT that my scissors weren’t sharp enough to cut the linea alba. I didn’t have mayo scissors in the pack, the metzembaum scissors were not sharp enough, and then I had some sharp and blunt pointed scissors that I didn’t feel comfortable sticking the pointy end into the abdomen where I couldn’t see. It just goes to show have much ‘cleaner’ and faster a surgery can be if you have the appropriate instruments! Additionally, you can cause more trauma when you are manipulating tissues through a tiny incision.

So, I ended up having to put the dull scissors aside and go back to the technique I used in school using the scalpel blade to extend the incision. Don’t worry, my surgery supervisor taught me a technique with the forceps and blade so the blade never goes into the abdomen.

This morning I was browsing Instagram, as I do when I don’t want to get out of bed right away, and came upon a post on how to enter the abdomen. This post just goes to show how much cleaner, easier and less traumatic it is for the patient! It just means I need to push a little bit harder to get the appropriate instruments.

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