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Celiotomy vs Laparotomy

Today we are going to cover the surgical terms celiotomy and laparotomy, what they mean, how they are different, and what to expect if your pet is going to be having one performed.

Later we will discuss the preparation you can do for your pet beforehand, what happens during the procedure, and what post-operative care will be required.

Dog with the vet in the background writing the list - I Love Veterinary

Definitions

A celiotomy is a surgical procedure where the abdomen of an animal is accessed through the midline. The midline is the point of the body extending from the base of the sternum through the umbilical region and extending to the pelvis in a straight line. This line is parallel to the spine. If you have ever had your female dog neutered (also known as spayed), then they would have had a celiotomy performed.

A laparotomy is also a surgical procedure where the abdomen is accessed, but instead of going through the midline, an incision is made to one side. This way of accessing the stomach is commonly seen in female cat neuters, especially in Europe, where this technique is preferred.

It is important to know that although these terms have specific meanings, the veterinary medicine field will generally use both terms to refer to surgery to access the abdomen. 

What’s the difference between a Celiotomy and Laparotomy

In day-to-day practice, the terms celiotomy and laparotomy are used interchangeably even though the procedures are different. The vast majority of the time, animals’ abdomens are accessed through the midline (celiotomy). 

This is because the midline contains a ligament called the linea alba. This ligament can be cut without damage to muscles and can reduce bleeding. It is also easier to stitch close because the ligament is tough and fibrous.

Laparotomies (accessing through the side) are less commonly performed because it requires cutting of muscle and can bleed more. Access to all the organs in the abdomen is also more difficult. 

Laparotomies are typically reserved for specific situations such as cat neutering by some veterinarians and if midline access is restricted, for example, in lactating animals or those with large wounds or masses at the midline.

Vet performing medical procedure on a cat - I Love Veterinary

Despite celiotomy being the most common technique, laparotomy is actually the term most commonly used to describe access to the abdomen. Throughout this article and other literature, laparotomy will be the preferred term. If you need clarification about which approach your veterinarian will be performing on your pet, it’s best to ask rather than assuming the words are being used accurately.

Laparotomies can be performed openly by cutting a large hole to fit fingers and hands into the abdomen or via keyhole surgery where small incisions are made that fit only instruments and cameras to look inside the abdomen.

Indications

Accessing your pet’s abdomen may be required for several various reasons. A few examples include:

  • Neutering female animals is probably the most common reason veterinarians will access the abdomen of your pet. The uterus and ovaries, which make up the reproductive organs, are found in the stomach and need to be removed to prevent pregnancy.
  • Removing undescended testicles in male animals is another common reason for abdominal surgery. When testicles don’t travel into the scrotum as they usually would, they can be found either in the inguinal (groin) region or in the abdomen. To remove abdominal testicles, a laparotomy needs to be performed.
  • Cesarean Section is performed by accessing a pregnant animal’s uterus through the abdomen and removing puppies or kittens that either can’t be born naturally or it is safest for them to be removed electively.
  • Trauma after being hit by a car or falling may damage internal organs inside the abdomen. Accessing the stomach surgically allows the repair of these vital structures, including stopping bleeding.
  • Masses and tumors in the abdomen may need to be removed or sampled; this may require opening up the abdomen to access the mass directly.
  • Exploratory laparotomy is a diagnostic procedure commonly performed to examine the organs and structures that reside in the abdomen of sick animals. If other diagnostic tools such as ultrasound can’t diagnose the problem, your veterinarian may recommend performing an exploratory laparotomy to look for the cause.

Surgical Anatomy

Group of vets examining Doberman's abdomen in vet clinic - I Love Veterinary

The abdomen is filled with many important structures. The list below explains some of the stomach’s critical structures but is certainly not an exhaustive list.

  • Digestive system: the stomach, intestines, pancreas, and liver are all in the abdomen and are all responsible for parts of the digestion process.
  • Urinary system: the kidneys, ureters, bladder, and urethra are all in the abdomen and help remove waste products from the blood and turn it into urine to be excreted.
  • Lymph nodes are found throughout the abdomen and drain a product called lymphatic fluid. Lymph nodes are essential in fighting infection and disease.
  • Venous system: large arteries and veins course through the abdomen providing essential nutrients to cells. The spleen is another major organ in the stomach that helps produce white blood cells and break down old red blood cells.
  • The endocrine system is responsible for producing hormones. In the abdomen, the adrenal glands and the pancreas are two examples of endocrine organs.

How to Perform One

When your pet arrives for surgery, they will likely be checked over to ensure they are healthy enough to be anesthetized. Then they will be given a sedative to make them sleepy, and this medicine will likely include pain relief to make them comfortable. 

Once your pet is sedated, more medicine will be given to anesthetize them. Once your pet is asleep, fur will be clipped off to provide a clear space for surgery to be performed. Once the coat is removed, the area will be well cleaned with surgical scrub to remove any bacteria that might cause infections. 

The veterinary surgeon will then prepare themselves to ensure they are clean and ready for surgery.

Once your pet and the surgeon are ready for surgery, a cut will be made to access the abdomen. Depending on the indication of the surgery, specific procedures will then take place. For example, if your pet is being neutered then the reproductive organs will be removed. If your pet is having an exploratory laparotomy, all the abdomen structures will be carefully inspected for signs of abnormality such as masses or foreign bodies. 

Vet preparing dog for surgery - I Love Veterinary

When the veterinarian is finished with the laparotomy, the abdomen will be closed with suture material, and your pet will recover from the anesthetic and wake up.

Once your pet has recovered from the anesthetic, they will be ready to go home or continue to stay in the hospital if they are unwell.

The surgical wound usually takes 10-14 days to heal, but this may vary depending on the procedure performed and how sick your pet is. It’s important to note that wounds heal from skin edge to skin edge, so a wound 1.96 inches and 19.68 inches will heal in the same length of time.

Preparation as an owner

Suppose your pet will be having abdominal surgery; your veterinary team will advise on the best way to prepare. In general terms, usually, animals will need to be fasted before abdominal surgery to prevent vomiting while anesthetized. This will usually mean no breakfast on the day of surgery but not always, so make sure to ask.

On the day of the procedure, you may bring your pet to the clinic if they aren’t already there for them to be admitted. Someone from the veterinary team will ask you questions and get your consent for the procedure. If you have any last-minute questions, this is an excellent time to ask them. 

Once you are happy, your pet will be admitted into the hospital to await their surgery. During this time, you will usually be recommended to go home to wait for a call to advise it has finished. 

If your pet is having a laparotomy as an emergency procedure, such as after an accident, this preparation might look very different.

Equipment

Surgery equipment - I Love Veterinary

The equipment used to perform a laparotomy can vary greatly depending on exactly what is being done. 

In general terms, some examples of equipment used include:

  • Scalpel to cut the skin to be able to access the abdomen.
  • Scissors to cut tissue and suture material.
  • Swabs and sponges can be used to absorb blood and other fluid.
  • Forceps are used to grab tissue, clamp blood vessels and hold needles for suturing.
  • Suture material is used to close the abdomen after surgery so that the edges of muscle and skin can heal.
  • Needles are used to push suture material through tissues.
  • Suction apparatus can be used to remove excess blood and fluid.

Post-operative care

Abdominal surgery is a significant procedure, and your pet will need to be well looked after post-operatively. Your veterinarian will explain what your pet will need after surgery to help them recover. 

Pets are often prescribed medications that will need to be administered, such as pain medicine or antibiotics. Make sure to follow the instructions on the label and ask your veterinarian for advice. 

Your pet will need to be fed carefully after surgery and may need to have a different diet. This should be explained to you on discharge.

Any animal that has surgery will need time to recover from the surgery and anesthetic medications. Usually, this time will be aided by being kept in a warm, quiet place with limited access to the outdoors. 

If your pet is a cat, they may need to be provided with a litter box to use while they recover. If you have a dog, they may need to have lead walks to go outside to the toilet so that they can’t run and jump. 

Stitches may be internal or external; if they are external, they will need to be removed once the wound has healed. An Elizabethan Collar may be required to prevent your pet from chewing at their stitches.

Black dog with Elizabethan collar - I Love Veterinary

Key Takeaways

The terms laparotomy and celiotomy are used interchangeably to mean surgical access to the abdomen. Laparotomy is the term most commonly used by veterinarians.

Accessing the abdomen may be required for several reasons, including routine procedures such as neutering, as a diagnostic tool such as exploratory laparotomies, or as a treatment such as removing a tumor. 

The abdomen is full of many vital organs such as the stomach, intestines, kidneys, and liver. All of these structures can be accessed through a laparotomy.

Laparotomies can have varying healing times and prognoses depending on the reason for the procedure. Your veterinarian can help with more specific information.

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