Surgical Area

It would be beneficial to have two surgery rooms, one for small and another one for large animals, because of specific requirements in regard to equipment, surgical tables, and annexed rooms (Fig. 17-1). The surgical area must follow general standards in terms of security, patient and staff circulation, clean and comfortable environment, and proper organization, as described in literature reports.^9,12,14 A video recording system is of particular interest in these procedures as a means of documentation and sharing information.

Figure 17-1 Large animal surgical room at the Lisbon Zoo Hospital.

With the increasing sophistication of surgical techniques and instrumentation available today, surgeries outside a proper surgical facility are becoming less common.¹⁴ Nevertheless, occasionally, field surgery is still the option for zoo animals. This is the prevailing choice for large mammals or patients requiring short-duration anesthesia, or even for quick patient anesthetic recovery in an enclosure. In these circumstances, it is useful to have additional portable equipment available—namely, a good light, anesthesia device, oxygen tank, transport stretcher, and adequate surgical tables (e.g., inflatable systems; Fig. 17-2).

Figure 17-2 Field zoo animal surgery portable equipment, lights, anesthesia device, oxygen tank, transport stretchers, and inflatable surgical table.

In the perioperative period, being able to use nurseries and animal isolation facilities is essential to monitor the patient more suitably. However, this may not always be a valid option; it might involve isolating a member of a group for a period of time long enough to alter its social structure.

Surgical Instrumentation

Accesses, structures, and target tissues vary enormously, so a considerable range of materials must be available. One may consider three basic and relevant instrument packs:

TABLE 17-1 Basic Microsurgery Pack for Delicate Surgery*

* Binocular magnification loupes, 2.5 to 5×.

TABLE 17-2 Basic Pack for Small- to Medium-Sized Animals

TABLE 17-3 Basic Pack for Large Animals

These packs are the basis for any type of surgery and must be complemented whenever necessary, according to the specific intervention. Electrocautery and portable suction units are examples of valuable and accessible equipment that should be included. Moreover, a diversity of retractors is necessary; the most widely used and recommended are Senn and Farabeuf retractors and self-retaining retractors such as Gelpi, Weitlaner, Finochietto, Balfour, and Lone Star retractors. Lid retractors used for laparotomy in very small animals or handheld retractors with sharp prongs for handling very thick abdominal walls may be an option.

In recent years, technologic advances have led to unprecedented access to new surgical equipment. Although high prices normally delay the integration of newly developed equipment in veterinary medicine, it becomes more affordable over time. Nevertheless, surgeons must become familiar with equipment before its practical application, acknowledging its advantages and its potential limitations. The use of equipment such as stapling devices, surgical lasers, and recently developed vessel sealing systems has become increasingly more common. When used correctly, this equipment has proven its value. Stapling devices may decrease the time of surgery needed for anastomoses and ligations and may also minimize the associated contamination. LigaSure (Covidien, Mansfield, Mass), a modern bipolar vessel sealing system, and Ultracision (Ethicon, Somerville, NJ), a system of ultrasound energy–based shears, are more efficient methods of coagulation when compared with monopolar and bipolar electrocoagulation.⁷