Options for Teaser Bull Surgical Procedures Kathy Whitman DVM MS Great Plains Veterinary Educational Center Gomer bull selection Purpose heat detection synchronization estrus induction Mature virgin bulls free of STDs and other biosecurity risks ID: 772498
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Options for Teaser Bull Surgical Procedures Kathy Whitman, DVM, MS Great Plains Veterinary Educational Center
Gomer bull selection Purpose: heat detection, synchronization, estrus inductionMature, virgin bulls, free of STDs and other biosecurity risksStructurally sound and sufficient sizeLibido with limited human riskAdditional history?
Surgical preparation 24-48 hour fast for ruminating bovinesPhysical examDoes he have nuts??????Anesthetic riskAncillary testingPCV/TPAnesthesia/analgesia/antibiotics Positioning Generally dorsal recumbency Appropriate padding Tilted for surgeon preference Well restrainedProtect eyes
Surgical preparation Aseptic procedure!!!Scrub and prep like you’re a surgeon and it mattersClip-flank to flank, scrotum to xyphoidAseptic scrub, +/- drapeClamp or purse string sheath to minimize urine contamination Instrumentation/surgery pack Sterile Plan for worst case scenario-what would you require? Suture choice Scarring is good in most cases-do you want it to resorb? Don’t put it where it’s not needed-ex. epididymectomySuture removal?
Surgery similarities Patient positioningPatient preparationBe confident in making incisionUse scissors-better control, better hemostasisControl hemorrhages as needed-take time to ligateLimit time, trauma, and contaminationReduce dead space if necessaryContinuous pattern for skin is sufficient Sexual rest is required in all situations-up to 6 weeks if uncomplicated
Various surgical methods EpididymisEpididymectomy Iatrogenic necrosis Vas deferens Vasectomy Vasostomy Penis PenectomyPenopexy Phallectomy Translocation
Epididymis Epididymectomy Can be performed standing with local block Use in combination with other procedures Emasculotome A problem if proper clamp is not applied-per spermatic cord Maintain libido? Caustic procedures Ethical? Humane?
Vas deferensVasectomy Ligation and transection of the vas (ductus) deferensVasostomyTransection and reattachment to exteriorAllows for evacuation of semenTedious and no clear advantage over vasectomy
Vas deferens-VasectomyPerformed standing, lateral, or dorsal recumbencyPreparation of scrotal neck with local block1-2 in vertical incision in neck of scrotum, proximal to testicleExtend into tunica dartos to expose spermatic cordBlunt dissection to continue through tunica vaginalis to isolate ductus deferens Visualize cremaster, vein, and artery-AVOID ligating/transecting these Two ligatures (absorbable, monofilament) 2 in apart, transect Close tunics and skin
Penis/prepuce Penopexy (penile fixation)Penis is fixed to prevent extension-high and low optionsPenectomy U rethrostomy with penis removal-high and low options Phallectomy Amputation of distal penis TranslocationTunnelingZ-plasty
Penopexy (low) Surgical prep and line blockIdentify preputial reflection Use of a vaginal speculum to protect penis and identify reflection is useful Incise caudal to reflection, lateral to penis Using blunt dissection, isolate a 4-6 cm section of penis Place 3 interrupted sutures (non-absorbable, #3) through the tunica albuginea of the dorsal penis Again, avoid important structures Secure to the linea alba Simple interrupted to close skin Rest 2-3 weeks
Penopexy Body Wall Linea alba Tunica albuginea Non-absorbable suture, uninterrupted simple continuous
Penectomy /Phallectomy Standing procedures Use caudal epidural and pudendal blocks +/- Light sedation Keep urethra patent
Penectomy-”high heifer”
Translocation-Tunneling Surgical prep and line block, block flank incision siteCircumferential incision around prepuce extending caudally to base of the scrotum-speculum as a guide and contamination control or purse stringCircular incision and removal of tissue cranial to flank fold (45 from distal aspect of midline incision) Dissect penis within prepuce until it is freed from underlying tissues Using uterine forceps or instrument of length, create a tunnel from the distal end of the midline incision Place sterile sleeve or speculum thru tunnel Draw penis through sterile apparatus and bring through flank hole Suture subcutis (if needed) and skin
Penile Translocation-Z-plasty
Penile Translocation-Z-plasty
Surgical concerns… Bull waking up…Hopefully you tied good knots…Re-dosing is okay, do not compromise good technique for speedNot sure where to cut or how to proceed?When a problem presents itself, the time for preparation has passedStop, breath, ask questionsBleeders Unclamp yourself and clamp the bleeder-ligate as needed Address this issue up front-surgical field will be poor if you ignore Puckered skin when suturing Remove “dog ears” when seal is complete Remove suture and begin again We’ll tease you if it’s ugly, we’ll be upset if it comes apart
Post surgical careReturn to recumbency should be rapid, but don’t rush to get them up<30 min standingMonitor for excessive bleeding and/or swellingAppetite should be back to normal relatively quickly if pain management is appropriate and no complications
Post surgical problemsTypically minimal with z- plastyAbscess, dehiscence, systemic infection, etc.Iatrogenic urinary obstructionIntromission still possible…Discussion all potential issues with owner!!!!