VeterinarySurgery: canine ovariohysterectomy
Another candidate anesthetizes the dog and you are the surgeon: you prepare the patient and yourself for aseptic surgery and perform an elective spay, from the first clip to the last skin suture, in 2.5 hours. The examiner checks the ligatures and the abdominal closure before you go on. It is the Surgery section of the ECFVG Clinical Proficiency Examination.
Free to startScenarios
- A client-owned female dog of 6 to 28 kg, body condition 2 to 4 out of 5, not pregnant or in heat, that goes home after recovering in the hospital.
- A dog that turns out to be already spayed: you identify and show the ovarian pedicles and the uterine stump, and the examiner assesses your closure.
The steps
- Ask the technician for the supplies you need and direct every action they take.
- Remove the hair from the surgical site.
- Prepare the skin for aseptic surgery.
- Position the patient.
- Put on the surgical attire and scrub.
- Gown and glove aseptically.
- Drape the patient.
- If you contaminate yourself or the field during the preparation, tell the technician or the examiner at once and correct it.
- Make the surgical incision.
- Excise the ovaries, ligating each ovarian pedicle.
- Remove the majority of the uterus, ligating the uterine body.
- Show each ovarian pedicle and the uterine body ligatures to the examiner before releasing them into the abdomen, and leave the excised tract on the instrument tray.
- Handle the tissues gently.
- Keep hemostasis.
- Tie secure knots and ligatures.
- Tell the examiner when you are ready to close the abdominal wall, with the size and type of suture you will use.
- Close the abdominal wall and wait for the examiner to check it before going on.
- Close the subcutaneous tissue and the skin securely.
- After the incision, recognize any break in asepsis yourself, tell the examiner and correct it completely.
- Finish the whole procedure efficiently within 2.5 hours.
Safety rules that stop the station
- Not controlling significant hemorrhage, or not closing the abdominal wall securely, is a fatal flaw.
- Not achieving or keeping an aseptic field is a fatal flaw: before the incision you get one warning for a break you did not notice; a second one, or any unnoticed or uncorrected break after the incision, ends the section.
- Significant damage to other tissues, such as clamping or tying a ureter, or leaving an instrument or a sponge in the animal, is a fatal flaw.
To pass
- Surgery is pass or fail, with no number: 3 or more skills rated inadequate with low risk to the patient, or 1 rated inadequate with high risk or not done, fail the section.
- Not finishing within 2.5 hours, from the start of the patient preparation to the last skin suture, fails the section; time spent waiting for the examiner's checks is added back.
- The final result comes 24 hours after the surgery: a complication from a surgical error in that time, such as bleeding from a loose ligature or a hernia or dehiscence from a weak closure, counts against you.
Official source
Manual of Administration for the Clinical Proficiency Examination
The AVMA publishes the CPE Manual of Administration free: every station, its assessment sheet and the score needed to pass.
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