One of the most common surgical procedures we perform is a dog neuter, know medically as an orchectomy. It is performed for several reasons:
Pre-anesthetic preparation is important in every surgery we perform, no matter how routine. Surgery is not an area to cut corners. All of our neuters receive a physical exam prior to surgery. Only if they pass this exam will we draw a small amount of blood for an in-hospital pre-anesthetic test. When everything is in order we will give a sedative. This will calm the pet down and make the administration of the actual anesthetic, along with post operative recovery, much smoother. Once a pet is anesthetized, prepared for surgery, and had its monitoring equipment hooked up and reading accurately, the surgery can begin.
This page shows the surgical procdure for a normal testicle, a testicle that has not completely descended into the scrotum and is in the inguinal canal, and a testicle that is still in the abdomen.
The following area contains graphic pictures of an actual surgical procedure performed at the hospital.
The dog being neutered in this picture has only one testicle in the scrotum, called a cryptorchid or retained testicle. This happens in only a small percentage of the animals we neuter. The other testicle can be in the abdomen or in the inguinal canal (inner thigh region). In this dog's case it is in the inguinal canal, as evidenced by the bulge (arrow). It is important to remove the retained testicle because it can become cancerous later in life.
First we will remove the normal testicle. The procedure begins with an incision in the skin. We prefer to make our incision in front of the scrotum and not actually on the scrotum. This tends to minimize post operative licking and aids the healing process.
The testicle is gently squeezed forward and the incision over the testicle is made just big enough to gently squeeze it out. Smaller incisions heal faster, require less anesthetic time and there is less chance for complications.
The testicle bulges out of the incision cover by its internal layers called tunics. These tunics are carefully incised to expose the testicle and all its associated structures.
The blood supply to the testicle is brought out and two sutures are placed around it. After the testicle is cut the sutured tissue is placed back through the incision.
Two layers of sutures are used to close the incision. The first is called the subcutaneous layer, because it is the layer of tissue under the skin. Sealing this layer gives an added margin of safety, especially if the dog licks the area excessively.
The skin layer is frequently closed in a suture pattern called subcuticular. This layer is the underside of the skin. This technique gives a cosmetic appearance and makes it difficult for a dog to chew its stitches out.
Since our patient in this case has one of his testicles in the inguinal area, the surgery is not finished yet. The skin incision and exposure of the other testicle is similar to the normal testicle removal. In this region though, there is significant fat under the skin.
The actual structures of the testicle and its blood supply are exposed, ligated with two sutures, and placed back into the inguinal area.
The same 2 layer closure is used in the inguinal area also. First the subcutaneous tissue, then the skin .
Here is a final view of our patient and his two incisions. As he wakes up from anesthesia he will be given an injection for pain.
When the retained testicle is not in the inguinal area it is located in the abdomen. This testicle can also become cancerous so it is important to remove it.
In this case we have to make an incision near the tip of the penis and literally find this testicle in the abdomen. In this picture the testicle has been brought out through the 3 inch incision in the abdomen
It is ligated like all the other testicles that are removed.
Because we made an incision in the abdominal muscles it is imperative that these muscles are sewn back together properly. A hernia can result if the muscles don't hold together. This sutured muscle layer is identified in the picture as the tissue just to the left of the two headed arrow.
You can easily see the difference in size between the testicle that was in the scrotum on the right, and the testicle on the left which is the one that was in the abdomen.
This is the final look of the incisions sites for this dog with the testicle in its abdomen. The head is towards the right and it is laying on its back. At the far left is the skin incision from the removal of the normal testicle in the scrotum. At the far right is the incision from the testicle in the abdomen.
Most dogs recover from this surgery in a few days, even those that have incisions in their abdomen. It is important to keep these dogs quiet for a few days postoperatively to allow the incision sites to heal. In most neuters we put in sutures that are just under the skin and dissolve on their own, so there is no need to return for suture removal.
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