Monday, December 16, 2013

1270. Video Husky eyelid tumour vet surgery

Video not made by previous intern owing to lack of time.
Pl get video created

D:\2013Pic_After_Sep13

D:\2013Pic_After_Sep13\20130920Husky_eyelid_tumour_video

MVI 1009, 1010, 1019, 1020, 1021, 1043


Title: Veterinary Surgery video; How a Husky's eyelid tumour is removed.

Date: September 2013 case study.
Breed, age, gender
1. Hook.  Irritating. Keeps rubbing right eye. Eye inflamed. Consult vet for advice.

Clara to draw an illustration of how the surgery is to be done. .

2. Anaesthesia gas by mask and sedation by injection IV. 

3. Cut 1 cm incision in the lateral canthus to enlarge operating area

4. Cut around upper eyelid tumour with electro-incision electrode.
    An inverted "V" skin incision is made to remove the tumour

5. Ensure as much of the tumour area is removed by cutting off irregular skin edges at the margins of the excised tumour area.

CONFLICT 1. Profuse bleeding. What to do?
6. Electro-coagulation electrode is used to seal off bleeding vessels
7. Undermine skin below eyelid to reduce skin tension and prevent stitch breakdown. 
The skin edges are stitched. Blunt edged scissors is used.

CONFLICT 2. 
8. Bleeding present again.  
9. Electro-coagulation takes longer time as bleeding is profuse. Increase coagulation power to No. 2 (vet's voice)
10. Swabs to clear operating area of blood for stitching
      Takes a long time to coagulate blood vessel as it is large. Continue electro-coagulation.

CONFLICT 3. Insufficient skin area to stitch eyelid area if a wider margin of the tumour is excised. A margin of 1 cm is advised in vet text books but this is not practical here as there will be no skin to stitch up.
.
11. Tumour excised. Check again for remnants of tumour. Trim edges to provide a straight regular skin edge to stitch up for proper healing.
.
12. Skin now stitched with 3/0 absorbable sutures. Two interrupted stitches.
13. The lateral canthus is stitched now with one stitch. isoflurane and O2 gas anaesthesis is switched off during the 2nd last stitch (vet's voice to switch off anaesthesia).

14. Dog recovery stage MVI 1043.  No complaints from owner for the past 3 months.

Operating surgeon; Dr Sing Kong Yuen
Assisting surgeon: Dr Daniel Sing

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