Page 238 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 17 · Surgery of the diaphragm
y of the diaphragm
Chapter 17 · Surger

➜ OPERATIVE TECHNIQUE 17.1 CONTINUED
VetBooks.ir

Cranial ventral midline laparotomy. Exposure of the diaphragm. Repositioning liver lobes. Division of adhesions.

Examination of tear in diaphragm. Placement of dorsal suture in diaphragm. Closure of the defect.

POSTOPERATIVE CARE
Following reduction of a chronic hernia, replacement of the organs and loss of abdominal domain may cause an
increase in intraperitoneal pressure and resulting impairment of venous return. Careful monitoring of cardiovascular
haemodynamics is important. Supplementary oxygen therapy may be required if there is ventilatory insufficiency. If this
persists, aspiration of the chest tube or thoracic radiography should be performed to ensure that this is not due to
continuing pneumothorax. The chest drain is aspirated on recovery and every 1–4 hours as required, and is removed
once no longer productive, e.g. after 24–48 hours. Analgesia is maintained with systemic opiates and non-steroidal
anti-inflammatory drugs.

229
229

Ch17 HNT.indd 229 31/08/2018 13:45