Ventral Midline Preputial Approach to the Caudal Abdomen in Male Dogs

Abstract

Objective: To describe a ventral midline preputial approach to the caudal abdominal cavity of male dogs. Study Design: Retrospective clinical study. Sample Population: Client-owned dogs (n512). Method: Medical records of dogs which underwent a ventral midline preputial approach to the caudal abdominal cavity were reviewed. The procedure, outcome, and complication were recorded. Results: Dogs underwent the preputial approach to the caudal abdominal cavity for various conditions. All dogs had an uneventful postoperative recovery and no major complications were recorded until suture removal at 10-14 days postoperative. Two dogs had minor complications treated conservatively which resolved. Conclusion: The use of ventral midline preputial approach is an option for access to the caudal abdomen. The approach preserves the protractor preputii muscles, obviates ligation of the branches of the caudal superficial epigastric vessels and eliminates the need for extensive subcutaneous dissection.A limited caudal abdominal approach in the male dog is usually performed for exposure of the prostate gland, exposure of the urinary bladder and exploration of the caudal abdominal structures in this area. The standard approach involves a parapreputial skin incision and dissection of the abdominal subcutaneous tissues to expose the caudo-ventral midline and linea alba.1 This approach involves extensive subcutaneous dissection, severance of the preputial muscles, and ligation of the branches of the caudal superficial epigastric vessel. The objective of this paper is to describe an alternate approach to the caudal abdominal cavity in male dogs via a ventral midline preputial incision. MATERIALS AND METHODSMedical records at The University of Zurich Veterinary Teaching Hospital and Miami Veterinary Specialists were searched for cases where a ventral midline preputial approach to the caudal abdominal cavity was used. A total of 12 male dogs with postoperative evaluation were included. Surgical ApproachDogs were prepared for aseptic abdominal surgery. The urinary bladder was manually expressed or urine removed via urethral catheter before surgery. The ventral abdomen was clipped free of hair from the xiphoid caudally to the pubic margins. The skin was prepped with povidone iodine scrub in a series of three scrubs. The prepucial fornix was lavaged with either 1% povidone iodine solution, or 0.05% chlorhexidine solution.2 The dog was then positioned on the operating table in dorsal recumbency with the hind limbs in extension (Fig 1).An incision was made through the skin and subcutaneous tissue (external lamina of the prepuce). The incision was centered over the ventral midline of the prepuce beginning cranially, approximately 1.0 cm caudal to the fornix of the prepuce and extending caudally to the base of the prepuce (Fig 2). Hemostasis was performed as necessary with monopolar electrocoagulation. The incision exposed the ventral aspect of the internal preputial lamina (Fig 2). The penis underlying the exposed internal lamina was then retra...

WSAVA guidelines for the control of reproduction in dogs and cats

“…Adequate exposure is critical when performing cryptorchidectomy. A ventral midline preputial approach to the caudal abdomen has been described and eliminates the need for extensive subcutaneous dissection while decreasing potential problems with haemorrhage from the caudal superficial epigastric vessels (Daniel et al., 2016) (Figs 44 and 45). This method may be appropriate if the retained testis is known to be located in the caudal abdomen near the deep inguinal ring.…”