Tuesday , 17 October 2017

Routine Surgery: There’s no Such Thing

By Dr. Ed Mapes, Stonebridge Animal Hospital

No surgery is “routine.”  Even though some procedures are done more frequently than others, patients are at risk for anesthetic or surgical difficulties during every single procedure that is done.  That is why we take precautions to ensure that animals are in suitable condition to undergo anesthesia and surgery, and why we monitor their progress very closely during surgery to detect any abnormality and take corrective measures at once.

We don’t really have to do thorough examinations of patients before procedures. There is no law stating that we must do pre-operative blood screening, especially on young patients.  Installing an intravenous catheter to give fluids during anesthesia to maintain blood pressure isn’t mandated by any federal or state regulation; it’s just better medicine to keep patients safe.

Hooking patients up to monitoring machines can be a pain in the neck; all those wires to connect and dials to adjust and the noise of the EKG readout; the machines always seem to get in the way.  How do we fit all this equipment into the room; and where do we stand to do the operation?  Why go to all this effort?

Because monitoring the EKG, pulse oximetry, blood pressure, breathing rate and temperature is the best way for us to know how the patient is doing on a constant basis.  Without these contraptions we can see that they’re breathing, but can’t tell much else.  When we use the laser there’s not even bleeding to tell us that the heart still pumps.  Nobody forces us to buy this outrageously expensive equipment – it just lets us do better and safer surgery for our patients and it seems worthwhile to me.

Figure 1 the equipment used during every “routine” procedure and the more complex surgeries as well.  From left around the surgery table:

• Mayo instrument stand
• Laser surgical unit
• Surgical monitor
• Pump for warm water circulation to control hypothermia
• Anesthetic machine
• IV stand with infuser and bags of intravenous fluid
• Suction device used during laser operation
• Twin surgical lights above table

All this extra testing and examining and catheterization and monitoring is a lot of work and takes up a lot of our time.  True, it adds some expense when compared to having surgeries performed without these measures.  It all comes down to risk versus chance, and while the odds are that most patients will survive, facts dictate that animals are harmed and do die during surgery.

Our pets are spayed or neutered once in their lifetimes.  Does it make better sense to roll the dice and hope they come through it unscathed, or to take a few precautions when they’re on the operating table and do what we can to make sure they go home after surgery?

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