Untitled Lesson

Rumenotomy

Lilly & Lauren

Indications

●Vagal indigestion

●Hardware disease

●Rumen acidosis

●Some forms of choke

Exploration of the…

●Rumen

●Reticulum

●Parts of omasum

Relevant anatomy

Preop management

●Off feed for 24 hours

●Preoperative NSAIDs

●Preoperative antibiotics

●Regional anesthesia

●Positioning & setup of cow

●Supply setup

Surgical procedure

●Incision into the peritoneal cavity

○If hardware disease, incise as close to the last rub as possible

○If foreign body retrieval, central incision

●Abdominal exploratory

●Tack the rumen

●Contamination management

●Rumenotomy

●Rumen & body wall closure

Tack the Rumen

●Tack rumen to the body wall on either side of the incision

●1:00 and 11:00 position

●Repeat tacks until rumen is secure

●AKA: “stay suture rumenotomy (SSR)”

Other tacking Approaches &
Contamination Prevention

Water-tight seal via inverting suture pattern

Rumen skin suturing fixation (RSSF)

Rumen Protector

Weingarth’s Ring

Rumenotomy (WRR)

Rumen board

Contamination Management

●Rumen exteriorization (previously discussed)

●Separate instruments

●Waterproof cover for surgeon

Rumenotomy

●Wound/Rumenotomy drape

●Incision into rumen

●Remove ingesta

●Rumen exploration including reticulum, esophageal opening, and omasal
opening

●Any abscess should be drained into the rumen

●Removal of hardware

●Addition of a magnet if one is not there

●Transfaunation if appropriate

●Do NOT lavage the abdomen if contamination occurs

Rumen closure

●Remove rumen drapes & shields

●Clean surface of rumen

●1 layer closure

●Removal of contaminated drapes, equipment, and waterproof gown/trash bag

●Second layer inverting pattern-closure

●Remove tacks from rumen slowly

●Clean rumen surface well

Body wall closure

●1st layer: internal abdominal oblique and transversus

○2 chromic gut

○Simple continuous

○Burp before finishing

●2nd layer: external abdominal oblique

○Similar to 1st layer

○No burping necessary

●3rd layer: skin closure

○3 or 5 nonabsorbable suture (nylon)

○Ford interlocking

Postop

●Suture removal in 10-14 days

●Monitor for infection/peritonitis

●Rumen transfaunation if appropriate

Complications

●Cow lays down

●Incisional dehiscence

●Incisional infection

●Peritonitis

References

●open.lib.umn.edu/largeanimalsurgery/chapter/how-to-rumenotomy/

●Rumen protector photo

●Rumen board photo

●chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/file:///C:/Users/laure/D
ownloads/22_Maroney.pdf