ILMU BEDAH KHUSUS VETERINER

TEKNIK OPERASI GASTROTOMY DAN RUMENOTOMY

DISUSUN OLEH :

KELOMPOK 4

Ni Made Adinda Arya Ningrum 1809511015

Ni Made Rita Adnyani 1809511017

Kadek Leni Martha Diana 1809511019

Putu Devindia Trisha Suciada 1809511030

FAKULTAS KEDOKTERAN HEWAN

UNIVERSITAS UDAYANA

DENPASAR

2021
 KATA PENGANTAR

Puji syukur kepada Tuhan Yang Maha Esa yang telah memberikan rahmat dan karunia-
Nya kepada penulis, sehingga dapat menyelesaikan paper yang berjudul “Teknik Operasi
Gastrotomy Dan Rumenotomy”. Penulis juga mengucapkan terima kasih kepada Dosen Mata
kuliah Ilmu Bedah Khusus Veteriner yang telah membimbing dan menuntun penulis dalam
menyelesaikan paper ini dengan baik.

Penulis menyadari bahwa paper ini masih jauh dari kesempurnaan dan masih banyak
kekurangan karena keterbatasan yang dimiliki oleh penulis. Oleh karena itu, dengan segala
kerendahan hati penulis mengharapkan adanya kritik dan saran yang sifatnya membangun untuk
kesempurnaan paper ini. Paper ini tidak akan terwujud tanpa adanya bantuan berbagai pihak baik
bantuan secara langsung maupun tidak langsung.

Atas segala bantuan yang diberikan penulis mengucapkan terima kasih dan penulis
memohon maaf atas banyaknya kekurangan yang dimiliki dalam paper ini sehingga dengan
adanya paper ini diharapkan dapat menjadi ilmu bagi yang membacanya.

Denpasar, 2 Oktober 2021

Penulis

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 DAFTAR ISI

KATA PENGANTAR ................................................................................................... ii

DAFTAR ISI .................................................................................................................. iii

DAFTAR GAMBAR ..................................................................................................... iv

BAB I PENDAHULUAN ............................................................................................... 1

1.1 Latar Belakang .................................................................................................... 1

1.2 Rumusan Masalah ............................................................................................... 2

1.3 Tujuan ................................................................................................................ 2

1.4 Manfaat .............................................................................................................. 2

BAB II TINJAUAN PUSTAKA ..................................................................................... 3

2.1 Terminologi ......................................................................................................... 3

2.2 Indikasi .................................................................................................................4

2.3 Anestesi ................................................................................................................5

2.4 Praoperasi .............................................................................................................5

2.5 Operasi .................................................................................................................7

2.6 Pasca Operasi .....................................................................................................17

BAB III PENUTUP ........................................................................................................19

DAFTAR PUSTAKA .....................................................................................................20

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 DAFTAR GAMBAR

Gambar 1. Pencukuran daerah ventral abdomen ............................................................... 7

Gambar 2. Ilustrasi daerah gastrium yang akan dioperasi .................................................. 8
Gambar 3. Pengeluaran benda asing dari gastrium ............................................................. 8
Gambar 4. Pengangkatan gastrium keluar tubuh ................................................................ 8
Gambar 5. Penjepitan gastrium dengan hemostat dan melakukan jahitan stay suture ....... 9
Gambar 6. Insisi di daerah penjepitan gastrium ................................................................. 9
Gambar 7. Pengikatan ujung sayatan dan dikencangkan ................................................... 9
Gambar 8. Penjahitan bagian mukosa gastrium dengan tipe jahitan menerus sederhana ........ 10
Gambar 9. Penjahitan (submukosa, muskularis, dan serosa) .............................................. 10
Gambar 10. Insisi dilakukan pada daerah flank ................................................................. 12
Gambar 11. Dilanjutkan dengan insisi fascia .................................................................... 12
Gambar 12. Rongga abdomen terbuka................................................................................ 13
Gambar 13. Pemasangan bingkai wein garth (buka daerah insisi) ..................................... 13
Gambar 14. Pengeluaran rumen dengan tang arteri ............................................................ 13
Gambar 15. Pemasangan kain drap .................................................................................... 14
Gambar 16. Insisi dilakukan pada rumen .......................................................................... 14
Gambar 17. Pemasangan backhaus towel clamp (untuk membuka rumen) ....................... 15
Gambar 18. Pengeluaran benda asing ................................................................................. 15
Gambar 19. Pelepasan clamp dan penjahitan lembert ....................................................... 15
Gambar 20. Memasukkan kembali rumen ......................................................................... 16
Gambar 21. Penjahitan fascia dengan tipe jahitan simple continuous ................................ 16
Gambar 22. Fascia selesai dijahit........................................................................................ 16
Gambar 23. Penjahitan kulit subkutan ............................................................................... 17
Gambar 24. Proses penjahitan selesai ................................................................................. 17

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 BAB I

PENDAHULUAN

1.1. Latar Belakang

Ilmu bedah veteriner merupakan cabang ilmu pengetahuan yang memaparkan tentang ilmu
bedah veteriner secara umum dan teknik operasi untuk dapat melakukan proses pembedahan
dengan benar. Menurut pedoman standar perawatan untuk operasi hewan, dapat dilakukan
secara bervariasi tergantung jenis dan tujuan dari hewan tersebut. Anjing dan kucing
merupakan hewan kesayangan yang banyak digemar anyak digemari oleh masyarakat. Banyak
diantara hewan kesayangan tersebut mengalami gangguan penyakit gangguan penyakit
sehingga sehingga harus menjalani pembedahan. Salah satunya pembedahan di saluran
pencernaan seperti pada gastrium.
Gastrium merupakan bagian dari alat pencernaan pencernaan pada hewan non ruminansia.
Pada kucing dan dan anjing letak pada sisi kiri linea alba cranial abdominal dibelakang
diafragma dan hepar. Letaknya bervariasi tergantung dari dari jumlah jumlah isi jumlah isi
gastrium. Kasus gastrointestinal pada hewan kesayangan (kucing dan dan anjing) yang
mengharuskan dilakukannya gastrotomi adalah kasus foreign body removal (pengangkatan
benda asing) yang sering ditemukan pada hewan di bawah umur 2 tahun. Gastrotomy
dilakukan dilakukan pada hewan non ruminansia, sedangkan hewan ruminansia misalya pada
sapi dilakukan Rumenotomy.
Rumenotomi merupakan salah satu teknik operasi membuka rumen pada ruminansia,
akibat adanya indikasi-indikasi tertentu yang akhirnya membutuhkan tindakan operasi
pembukaan rumen. Rumenotomy biasanya dilakukan dengan posisi berdiri pada sapi, dan
lateral recumbency pada hewa pada hewan ternak kecil, yang kemudian diberdirikan dengan
menggunakan meja inverted “L” block dengan anestesi line block, inverted block, atau
paravertebral block.

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Rumusan Masalah

Adapun rumusan masalah yang akan dibahas pada paper ini, yaitu :
1. Bagaimanakah Terminology Dari Teknik Operasi Gastrotomy Dan Rumenotomy?
2. Bagaimanakah Indikasi Dari Teknik Operasi Gastrotomy Dan Rumenotomy?
3. Bagaimanakah Anestesi Dari Teknik Operasi Gastrotomy Dan Rumenotomy?
4. Bagaimanakah Praoperasi Dari Teknik Operasi Gastrotomy Dan Rumenotomy?
5. Bagaimanakah Operasi Dari Teknik Operasi Gastrotomy Dan Rumenotomy?
6. Bagaimanakah Pasca Operasi Dari Teknik Operasi Gastrotomy Dan Rumenotomy?

1.2.Tujuan
Berdasarkan dari rumusan masalah tujuan dari penulisan paper ini yaitu:
1. Untuk mengetahui terminology dari Teknik Operasi Gastrotomy Dan Rumenotomy
2. Untuk mengetahui indikasi dari Teknik Operasi Gastrotomy Dan Rumenotomy
3. Untuk mengetahui anestesi dari Teknik Operasi Gastrotomy Dan Rumenotomy
4. Untuk mengetahui praoperasi dari Teknik Operasi Gastrotomy Dan Rumenotomy
5. Untuk mengetahui operasi dari Teknik Operasi Gastrotomy Dan Rumenotomy
6. Untuk mengetahui pasca operasi dari Teknik Operasi Gastrotomy Dan Rumenotomy
1.3. Manfaat
Manfaat dari penulisan paper ini, yaitu untuk memberikan informasi dan pengetahuan
mengenai Teknik Operasi Gastrotomy Dan Rumenotomy yang diharapkan dengan adanya paper
ini dapat memberikan pemahaman kepada pembaca dan penulis dalam menambah ilmu
pengetahuan mengenai penjelasan mengenai Teknik Operasi Gastrotomy Dan Rumenotomy

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 BAB II

TINJAUAN PUSTAKA

2.1 Terminologi
2.1.1 Gastrotomy
Gastrium merupakan organ pertama pada saluran pencernaan (tractus digestivus) di
dalam cavitas abdominal yang dibatasi oleh oesophagus pada bagian depan dan pylorus pada
bagian belakang. Pembedahan gastrium merupakan operasi pembedahan yang dikenal dengan
nama gastrotomi. Gastrotomi adalah tindakan pembedahan dengan melakukan incisi pada dinding
lambung sehingga terlihat lumennya. Gastrotomy merupakan suatu pembedahan dengan
penyayatan untuk menghasilkan atau memberikan pemeriksaan yang akurat dalam lambung. Pakar
bedah menyanyat sebagian kecil atau sebagian besar daerah curvatura mayor dari gastrium.Oleh
ahli bedah pemeriksaan dapat dilakukan dengan uji X-ray, Endoscopy, uji-uji tersebut merupakan
langkah-langkah dalam mencegah masalah yang terdapat pada gastrointestinal.
2.1.2 Rumenotomy
Rumenotomi terdiri atas rumenotomi dan rumenal fistulation. Rumenotomi adalah
pembedahan dengan membedah dinding abdomen dan rumen akan terlihat. Setelah itu rumen dan
dinding abdomen dijahit, setelah itu rumen diincisi sehingga terlihat isi rumen. Melalui lubang
yang dibuat pada rumen dapat dilakukan palpasi pada daerah bagian dalam rumen atau reticulum.
Rumenotomi sering dipergunakan untuk menguras isi rumen dan mengganti isinya denganyang
baru. Sedangkan Rumenal fistulation adalah teknik untuk menangani penyakit bloat yang bersifat
kronik. Bloat yang bersifat kronik diakibatkan dari abnormalnya nervus parasympatik yang
mensupplay cardia rumen.
Hal tersebut karena beberapa penyakit yaitu reticuloperitonitis dan fibrinous pneumonia –
pleuritis yang terkena pada nervus vagus. Selain itu juga akibat dari pembengkakan lympa nodulus
atau abses liver karena ada bakteri Bacillus Lactis dari ambing yang menyebar secara hemoragi
dan berada di rumen menyebabkan rumenitis lalu bergerak menuju hati akibatnya hati menjadi
abses, terjadi gangguan fungsi hati sehingga hati tidak dapat melakukan metabolism protein. Sapi
akan mengalami hypoprotein dan berakibat pada hilangnya tonus sehingga rumen tidak dapat
mengeluarkan gas.

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2.2 Indikasi
2.2.1 Gastrotomy
Indikasi utama dilakukannya pembedahan gastrotomi adalah untuk mengeluarkan benda asing
(terutama pada hewan anjing dan kucing), memeriksa mukosa lambung yang luka (ulser),
neoplasma atau hypertropi, serta untuk tujuan biopsi dan diagnosis, neoplasma atau hipertropi dan
untuk mengambil spesimen biopsi, untuk mengurangi tekanan akibat gastrium terlalu berdilatasi,
distensi lambung serta penyempitan pylorus. Dan tumor lambung (gastrointestinal lymphoma) dari
gastrium dan oesophagus bagian bawah). Sebelum prosedur pembedahan harus dilakukan
pemeriksaan lengkap traktus gastrointestinalis, baik pemeriksaan fisik maupun radiologi, selain
itu juga harus dilakukan evaluasi keseimbangan fluid dan elektrolit yang harus dikoreksi sebelum
operasi
2.2.2 Rumenotomy
Dinding tubuh bagian kiri (yaitu flank) merupakan subuah portal yang mudah untuk
mengakses struktur gastrointestinal proksimal termasuk retikulum, lubang retikulo-omasal dan
rumen itu sendiri.
Indikasi untuk operasi pada rumen meliputi trauma reticuloperitonitis, rumen dan adanya
benda asing di rumen, frothy boat, vagal indigesti, kelebihan gandum (grain overload), toxin
ingestion dan chronic reoccuring bloat. Rumenotommy eksplorasi dapat dilakukan untuk
mengambil benda asing yang tertelan. Menggunakan rumen sebagai akses dapat mengurangi
retikuloperitonitis akibat dari eksplorasi retikulum.
Pengeringan abses perireticular dapat dilakukan dengan bedah rumenotomy. Indikasi lain
untuk melakukan rumenotomy yang meliputi penghapusan isi rumen dalam kasus menelan racun
akut, kelebihan biji-bijian, atau mengasapi berbusa. Rumenostomy bisa menjadi pilihan terapi
untuk hewan dengan bloat kronis, digunakan untuk memberikan nutrisi enterik, atau digunakan
untuk menempatkan Canula rumen.

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2.3 Anastesi
2.3.1 Gastrotomy
Anestesi yang digunakan dalam teknik operasi gastronomy yakni ketamin dan xylazine.
Dosis ketamin yang dianjurkan untuk anjing dan kucing adalah 10-20 mg/kg BB secara
intramuskuler. Ketika digunakan sebagai obat tunggal, ketamin tidak menghasilkan relaksasi
muskulus skeletal yang baik, dan dapat mencapai recovery dengan segara dan biasanya dapat
menyebabkan konvulsi pada anjing dan terkadang kucing. Untuk menghindari efek tersebut,
banyak dokter hewan yang menggunakan ketamin bersama-sama dengan diazepam,
acepromazin, xylazine thiobarbiturat atau anastesi inhalasi. Untuk xylazine dosis untuk anjing
adalah 1-2 mg/kg BB diberikan secara intramuskuler. Setelah pemberian anestesi, frekuensi
nafas dan denyut jantung dimonitoring setiap 5-10 menit sampai pembedahan selesai.

2.3.2 Rumenotomy
Anastesi yang dapat diberikan dengan cara line block, inverted block, atau paravertebral
block. Anastesi diberikan secara regional dengan menggunakan teknik paravertebral block
dan L-block. Anastesi ini dimaksudkan untuk mematikan rasa di daerah flank. Beberapa
peneliti merekomendasikan pemberian intravena obat pra-anestesi seperti acepromazine (0,1
mg/kg) atau ketamin (22 mg/kg) pada ruminansia kecil.

2.4 Pra-operasi

2.4.1 Persiapan Alat dan Bahan

Alat: Beberapa alat yang termasuk dalam prosedur operasi, yaitu: meja operasi, spuit, scapel,
needle, needle holder, tampon, stetoskop, sarung tangan, kain drape, lampu operasi, pinset
anatomis, gunting lurus dan bengkok, thermometer, Alli’s Forceps serta arteri klem anatomi.
Bahan: Kain drape, tampon, alkohol 70%, aquades, kasa steril, benang jahit absorbable dan
non-absorbable, perban, iodium tincture 3%, gloves, masker, spuite 3 ml, dan cairan infus
(NaCl fisiologis 10-20 ml/kgBB, subkutan) jika diperlukan; lalu obat yang perlu dipersiapkan
adalah premedikasi (Atrofin sulfat), anestesi (ketamine HCl 10 %, xylazine HCl 2 %), serta
antibiotik post operasi.
2.4.2 Persiapan Ruang Operasi
Ruang operasi harus dalam keadaan yang bersih, penerangan cukup, terdapat alas kaki khusus
dalam ruang operasi, meja operasi steril, dan alas (underpad). Ruang operasi dibersihkan

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dengan menggunakan disinfektan, sedangkan meja operasi di disinfektan dengan
menggunakan alkohol 70%.
2.4.3 Persiapan Pasien (Hewan)
Sebelum dioperasi, pastikan hewan berada dalam kondisi yang normal, karena sangat riskan
melakukan operasi pada hewan yang berada dalam kondisi yang tidak stabil. Lakukan
anamnesa dan pemeriksaan fisik (pengisian signalemen, pengukuran berat badan, umur,
pulsus, frekuensi napas, suhu tubuh, dan pemeriksaan sistem tubuh lainnya (digestivus,
respirasi, sirkulasi, saraf, dan reproduksi) dan jika perlu dapat dilakukan pemeriksaan
laboratorium untuk memastikan bahwa sistem dalam tubuh berfungsi secara normal. Hewan
yang sehat terlebih dahulu dipuasakan, yaitu selama 12 jam untuk puasa makan dan 6 jam
untuk puasa minum, hal tersebut dilakukan untuk mencegah vomiting dan kontraksi deflasi
terjadi ketika operasi berlangsung. Hewan yang akan di operasi selanjutnya akan diberikan
premedikasi dan site operasi, lalu pemasangan IV cateter, infus, dan anestesi.
2.4.4 Persiapan Operator
Persiapan operator maupun co-operator perlu juga diperhatikan. Operator harus memiliki
kompetensi yang baik dalam melakukan operasi agar operasi berjalan dengan lancar. Adapun
kompetensi tersebut meliputi pemahaman prosedur operasi; siap fisik dan mental; personal
hygiene yang meliputi kondisi sehat serta melakukan pembersihan diri (mencuci tangan
dengan sabun antiseptik, memakai baju operasi, glove, masker, dan penutup kepala); mampu
memprediksi hal-hal yang akan terjadi atau dapat menggambarkan bahaya yang mungkin
timbul pada pelaksanaan operasi serta memperkirakan hasil operasi (prognosis); dan terampil.

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2.5 Teknik Operasi
2.5.1 Teknik Operasi Gastrotomy
Setelah dilakukan pemeriksaan fisik dan radiograph, melakukan evaluasi terhadap
keseimbangan elektrolitnya.

 Selanjutnya hewan diberikan anestesi umum dan ditempatkan pada posisi dorsal
recumbency.
 Setelah itu melakukan incisi kulit pada ventral midline abdominal dari xipoid sampai pubis.
 Incisi dilanjutkan pada linea alba dan peritonium sehingga rongga abdominal terbuka.
 Dinding abdominal dikuakkan dengan retraktor sehingga gastrointestinal terlihat.
Lambung dikeluarkan dengan membuat jahitan stay suture yang bertujuan untuk
memegang dinding lambung.
 Selanjutnya melakukan incisi pada dinding lambung yang sedikit pembuluh darahnya
(bagian curvatura mayor).
 Incisi dibuat agar tidak dekat dengan pilorus dan incisi dilebarkan dengan gunting.
 Setelah dilakukan tindakan pada lambung (mengeluarkan benda asing, biopsi), segera
dilakukan penutupan pada serosa muskularis, dan submukosa sebagai lapis pertama dengan
pola jahitan cushing atau simple interrupted selanjutnya dijahit dengan pola lembert atau
cushing.
 Lambung dimasukkan ke dalam rongga perut dan dilakukan penutupan dinding perut.
 Pada bagian peritonium, linea alba, dan subkutan dijahit dengan benang absorbable serta
kulit dijahit dengan benang nonabsorbable.

Gambar 1. Pencukuran daerah ventral abdomen

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Gambar 2. Ilustrasi daerah gastrium yang akan dioperasi

Gambar 3. Pengeluaran benda asing dari gastrium

Gambar 4. Pengangkatan gastrium keluar tubuh

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Gambar 5. Penjepitan gastrium dengan hemostat dan melakukan jahitan stay suture

Gambar 6. Insisi di daerah penjepitan gastrium

Gambar 7. Pengikatan ujung sayatan dan dikencangkan

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 Gambar 8. Penjahitan bagian mukosa gastrium dengan tipe jahitan menerus sederhana

Gambar 9. Penjahitan bagian submukosa, muskularis, dan serosa dengan tipe jahitan cushing
atau lembert untuk keamanan
2.5.2 Teknik Operasi Rumenotomy

Sebelum dilakukan operasi, hewan dipuasakan makan selama 12 jam dan puasa minum
selama 6 jam. Tujuan dari puasa ini adalah untuk pengosongan rumen supaya tidak mendesak
diafragma selama operasi sehingga tidak terjadi muntah. Dari hasil pemeriksaan umum dan
pemeriksaan fisik, hewan yang tidak mengalami perubahan patologis dapat dinyatakan hewan
berada dalam kondisi sehat dan aman untuk dioperasi.

 Sebelum operasi dilakukan, bagian yang akan dioperasi dicukur (daerah flank), setelah itu
diolesi alkohol.

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 Persiapan alat – alat operasi juga dilakukan. Perbedaan alat yang dipakai adalah pemakaian
shroud atau plastik untuk rumen. Setelah itu baru hewan diberi cairan anastesi.
 Anastesi yang dapat diberikan dengan cara line block, inverted block, atau paravertebral
block.
 Pada kasus rumenotomi biasanya anastesika diberikan secara regional dengan
menggunakan teknik paravertebral block dan L – block. Anastesi ini dimaksudkan untuk
mematikan rasa di daerah flank.
 Teknik ini mempunyai beberapa keuntungan seperti daerah yang teranastesi cukup besar,
menggunakan anastesi yang lebih sedikit dibanding anastesi lain dan tidak mengakibatkan
distorsi jaringan.
 Untuk memperoleh hasil anastesi yang sesuai, teknik ini membutuhkan keahlian serta
waktu untuk melakukannya dan peletakan agen anastesi haruslah tepat.
 Anastetika yang digunakan adalah Lidocain HCl. Pemberian Lidocaine HCL dilakukan
menggunakan metode farqurhason dengan processus transversus sebagai penanda.
 Tiap tempat diberikan injeksi Lidocaine HCl sebanyak 20 ml. Setelah sekitar 5 – 10 menit
kemudian, dilakukan tes untuk mengetahui apakah daerah operasi sudah teranastesi
sempuna atau belum, dengan menggunakan Allis forceps dilakukan jepitan – jepitan daerah
yang dianastesi tersebut.
 Setelah hewan teranastesi, dilakukan incisi sepanjang 12 cm pada kulit dimulai dari kira –
kira 10 cm di bawah prosesus transversus dari vertebrae lumbaris pertengahan flank.
 Struktur lain dari dinding abdomen yang harus dihindari saat insisi adalah nervus dan
pembuluh darah. Jika ada pembuluh darah harus di ligasi terlebih dahulu. Rumen ditarik
ke luar dengan bantuan allies forcep atau dua buah jahitan yang kuat.
 Incisi rumen dibuat diantara kedua jahitan setelah cavum abdomen ditutup. Setelah rumen
dibuka dimasukkan rumen shroud untuk mencegah kontaminasi kemudian isi rumen
dikeluarkan sehingga rumen dapat dieksplorasi untuk mencari benda asing.
 Tepi rumen yang diincisi dibersihkan dan dijahit dengan tipe jahitan sederhana menerus
dilanjutkan dengan tipe jahitan kontinous lambert dengan menggunakan benang catgut
chromic.
 Peritoneum dan muskulus dijahit secara terpisah dengan tipe jahitan sederhana tunggal
menggunakan benang catgut chromic.

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 Sub kutan dijahit dengan pola jahitan sederhana menerus menggunakan benang catgut
plain.
 Kulit dijahit dengan tipe jahitan sederhana tunggal menggunakan benang katun.
 Iodium tincture dioleskan pada luka.

Gambar 10. Insisi dilakukan pada daerah flank

Gambar 11. Dilanjutkan dengan insisi fascia

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 Gambar 12. Rongga abdomen terbuka

Gambar 13. Pemasangan bingkai wein garth (buka daerah insisi)

Gambar 14. Pengeluaran rumen dengan tang arteri

13
 Gambar 15. Pemasangan kain drap

Gambar 16. Insisi dilakukan pada rumen

14
Gambar 17. Pemasangan backhaus towel clamp (untuk membuka rumen)

Gambar 18. Pengeluaran benda asing

Gambar 19. Pelepasan clamp dan penjahitan lembert

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 Gambar 20. Memasukkan kembali rumen

Gambar 21. Penjahitan fascia dengan tipe jahitan simple continuous

Gambar 22. Fascia selesai dijahit

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 Gambar 23. Penjahitan kulit subkutan

Gambar 24. Proses penjahitan selesai

2.6 Pasca Operasi

2.6.1 Pascaoperasi Gastrotomy
Segera setelah penutupan dinding abdomen dilakukan penyuntikan Ampicillin 10 %
dengan dosis 10-20 mg/kg BB secara intramuskuler untuk menghindari adanya infeksi
sekunder. Selama hewan masih teranastesi, dilakukan infus RD 5 % untuk mengganti cairan
yang hilang dan untuk koreksi keseimbangan elektrolit secara intravena. Luka bekas operasi
diolesi salep bioplasenton.

Selain itu juga dilakukan monitoring terhadap denyut jantung, pernafasan dan
temperatur tubuh. Untuk mencegah keadaan hipotermi dapat dilakukan dengan menggunakan
lampu penghangat, selimut atau infus yang dihangatkan. Setelah hewan dioperasi ditempatkan
pada tempat yang kering dan bersih, luka operasi dijaga kebersihannya dan pemeriksaan
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dilakukan selama 4 – 6 hari berturut – turut, kemudian diberikan makanan yang mudah dicerna
guna mengurangi kerja gastrium selama 3 – 4 hari, jahitan dapat dibuka setelah luka operasi
benar-benar kering dan sembuh serta telah tertutup, kemudian diolesi kembali iodiun tinkture
3%.

2.6.2 Pascaoperasi Rumenotomy

Terapi pasca operasi yang diberikan adalah injeksi ampicilin 1,6 ml. Injeksi diberikan
secara intramuskuler 2 kali sehari. Pengobatan antibiotik ditujukan untuk mencegah terjadinya
infeksi baik yang diakibatkan oleh kurang terjaganya sterilitas operasi maupun akibat
masuknya agen penyakit atau bakteri melalui celah luka pada saat proses penyembuhan.

Ampicillin merupakan salah satu obat semi sintetik Penicillin yang paling penting,
mempunyai aktifitas bakterisid, merupakan antibiotik berspektrum luas, dan aktif melawan
sejumlah besar organisme gram positif dan negatif. Ampicillin bekerja dengan cara
menghambat sintesa dinding sel bakteri. Ampicillin didistribusikan ke seluruh jaringan tubuh
dan terpusat dalam hati dan ginjal. Dosis Ampicillin pada domba 10-20 mg/kg BB secara per
oral, dan 5-10 mg/kg BB secara parenteral.
2.6.3 Kemungkinan Komplikasi
Komplikasi gastrotomi dan rumenotomy adalah hemoragi, infeksi dan masalah – masalah
yang dihadapi sehubungan dengan anestesi dan shock. Hemoragi biasanya merupakan akibat
dari kelalaian atau ligasi yang tidak sempurna. Hemoragi sekunder dan adanya shock
merupakan komplikasi yang mungkin terjadi setelah penutupan luka. Infeksi adalah yang tidak
umum jika operasi dilakukan dibawah kondisi yang aseptis

18
 BAB III

PENUTUP

3.1. Kesimpulan

Gastrotomi adalah kasus foreign body rem Gastrotomi adalah kasus foreign body removal
(penga oval (pengangkatan benda ngkatan benda asing) yang sering ditemukan pada hewan di
bawah umur 2 tahun. umur 2 tahun. Gastrotomy dilakukan pada hewan non ru tahun. Gastrotomy
dilakukan pada hewan non ruminansia, sedangkan hewan ruminansia misalya pada sapi dilakukan
Rumenotomy.

Rumenotomi merupakan salah satu teknik operasi membuka rumen pada ruminansia,
akibat adanya indikasi-indikasi tertentu yang akhirnya akhirnya membutuhkan tindakan operasi
pembukaan rumen.

3.2. Saran

Dengan adanya paper ini diharapkan dapat berguna dan bermanfaat bagi pembaca untuk
mendalami dan memahami tentang penjelasan mengenai Teknik Operasi Gastrotomy Dan
Rumenotomy. Penulis tentunya masih menyadari jika makalah diatas masih terdapat banyak
kesalahan dan jauh dari kesempurnaan. Penulis akan memperbaiki makalah tersebut dengan
berpedoman pada banyak sumber serta kritik yang membangun dari para pembaca.

19
 DAFTAR ISI

Benchohra Mokhtar. 2017. An Alternative Method for Benchohra Mokhtar. 2017. An

Alternative Method for Rumenotomy Repair with One Rumenotomy Repair with One
Layer Closure Using the Fishing Line as a Suture Material. Department of Layer
Closure Using the Fishing Line as a Suture Material. Department of Biomedicine,
Institute of Veterinary Sciences, Ibn-Khaldoun University, Tiaret Biomedicine,
Institute of Veterinary Sciences, Ibn-Khaldoun University, Tiaret (14000), Algeria
Dehghani, SN and Ghadrdani AM. 1995. Bovine rumenotomy : Comparasion od FourSurgical
Techniques. Can Vet J Volume 36 pp 693-697
Fossum, Theresa W. 2013. Small Animal Surgery. 4th Fossum, Theresa W. 2013. Small Animal
Surgery. 4th Edition. Missouri: Elsevier Edition. Missouri: Elsevier Mosby Inc.
Geehan, AM, Amel OB, and Shnin H. 2006.Comparative Study of Two Rumenotomy
Techniques in Goats. Surgery Journal 1 (1) : 9-13
Gomez, JV. 2006. The Royal Canin Cut-out & Keep guide Gastrostomy tube placement in
dogs and cats. Watham Focus Vol 16 No 3. Pp 37-40
Majak, W, T. A. McAllister, D. McCartney, K. Stanford, and K-J Cheng. 2003. Bloar in Cattle.
Alberta Agriculture and Rural Development. Canada
Martin, Sergio., López, Adassa María., Morales, Manuel., Morales, Inmaculada., Junco, María
Teresa Tejedor., Corbera, Juan Alberto. 2021. Rumenotomy in small ruminants – a review.
Journal Of Applied Animal Research, VOL. 49, NO. 1, 104–108.
Ramaswamy, V And Sharma Hr.2011. Plastic Bags – Threat To Environment And Cattle Health:
A Retrospective Study From Gondar City Of Ethiopia. The IIOAB Journal Vol. 2; Issue 1;
2011: 7-12
Sudisma, IGN. 2006. Ilmu Bedah Veteriner Dan Teknik Operasi. Pelawa Sari. Denpasar.
Tobias, Karen M. 2010. Manual of Small Animal Soft Tissue Surgery. 1st Edition. Tobias,
Karen M. 2010. Manual of Small Animal Soft Tissue Surgery. 1st Edition. Iowa: Wiley
Blackwell Pub

20
 Journal of Applied Animal Research

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/taar20

Rumenotomy in small ruminants – a review

Sergio Martin, Adassa María López, Manuel Morales, Inmaculada Morales,

María Teresa Tejedor-Junco & Juan Alberto Corbera

To cite this article: Sergio Martin, Adassa María López, Manuel Morales, Inmaculada Morales,
María Teresa Tejedor-Junco & Juan Alberto Corbera (2021) Rumenotomy in small ruminants – a
review, Journal of Applied Animal Research, 49:1, 104-108, DOI: 10.1080/09712119.2021.1894156

To link to this article: https://doi.org/10.1080/09712119.2021.1894156

© 2021 The Author(s). Published by Informa

UK Limited, trading as Taylor & Francis
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JOURNAL OF APPLIED ANIMAL RESEARCH
2021, VOL. 49, NO. 1, 104–108
https://doi.org/10.1080/09712119.2021.1894156

REVIEW

Rumenotomy in small ruminants – a review

Sergio Martin a, Adassa María López a
, Manuel Morales a
, Inmaculada Moralesa, María Teresa Tejedor-Junco b,c

and Juan Alberto Corbera a,b

a
Department of Animal Pathology, Animal Production, Food and Science Technology, University of Las Palmas de Gran Canaria, Las Palmas de Gran
Canaria, Spain; bResearch Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain;
c
Department of Clinical Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain

ABSTRACT ARTICLE HISTORY

Rumenotomy is one of the most widely used surgical techniques for the diagnosis and treatment of Received 23 December 2020
different rumen conditions in ruminants. It is commonly used for large ruminants, such as cattle. Accepted 17 February 2021
Although this technique is also applied to small ruminants, there is a lack of standardization. To date,
KEYWORDS
it has not been fully described in the available literature, which is mostly from developing countries Rumenotomy; small
with a small number of peer-reviewed publications. This review is thus intended to summarize the ruminants; surgery; goat;
body of knowledge related to the technique that has been published so far and make it available for sheep; rumen
clinical practice. The indications for rumenotomy, preoperative management of patients, different
surgical techniques and postoperative management, including complications from the procedure, are
discussed.

Introduction
The digestive system of ruminants has the peculiarity of being
made up of four different compartments: the rumen, reticle,
omasum, and abomasum. The production of digestive
enzymes is reserved for the abomasum, so this chamber is
responsible for breaking down food (Phillipson 1999). Rumi-
nants are able to consume fibrous plant material, because the
fermentation processes carried out by the microorganisms
found in the rumen (mainly ciliated protozoa and bacteria,
but also yeasts) produce volatile fatty acids (VFAs). VFAs are
obtained from complex carbohydrates and other products
(such as proteins and B vitamins) (Ducharme 1990), and they
are absorbed mainly through the ruminal wall, or later in the
omasum and abomasum (Barcroft et al. 1944).
In small ruminants, the ruminal volume is estimated to be
approximately 5.3 litres, accounting for approximately 13% of
their body weight (Owens and Goetsch 1993). Other authors
estimate that the ruminal content in sheep is approximately
4-6 kg (Phillipson 1999), but these data may vary according
to the diet and transit through the digestive tract. In the case
of adult cattle, the estimated rumen volume varies between
102 and 148 litres (Oehme 1982) and accounts for around
16% of their body weight (Ducharme 1990).
Although most of the diseases affecting the gastroenteric
tract in ruminants are managed medically, some require surgi-
cal treatment (Radostits et al. 2007). Rumenotomy is one of the
most widely used surgical techniques in ruminants, and in
some regions it represents as much as 94% of all surgeries in
goats (Hayder 2004). Although the surgical technique is very
similar for small and large ruminants, the technique has been
widely described in cattle (Niehaus 2008; Callan and Applegate
2017; Martinez et al. 2019), but not so much in small ruminants.
However, rumenotomies are a common practice for the
removal of foreign bodies in goats (Hayder et al. 2006), and
this technique is also used for zootechnical or research pur-
poses (Martinez et al. 2019). Yet, it should be noted that
several particularities must be considered when the technique
is performed on small ruminants.
Indications
Several conditions have been reported that require the empty-
ing of the rumen. They can either be a dysfunction caused pri-
marily by failures in the transit or filling capacity of the rumen,
reticulopericarditis or reticuloperitonitis − which has rarely
been reported in small ruminants (Radostits et al. 2007)− or
processes that require greater urgency, such as cases of acute
ruminal acidosis or acute bloat (Das and Behera 2011; Lozier
and Niehaus 2016).
It is estimated that 50% of this type of surgery is performed
to remove foreign bodies from the rumen or reticulum
(Niehaus 2008). The accumulation of foreign bodies inside
the rumen reduces the absorption of volatile fatty acids and,
consequently, reduces the productivity of the animal. This
therefore has a great economic impact (Igbokwe et al. 2003).
In the specific case of small ruminants, they show a great
appetite for various materials difficult to digest, which can
produce bezoars or on occasion, an obstruction in the

CONTACT Juan Alberto Corbera juan.corbera@ulpgc.es Department of Animal Pathology, Animal Production, Food and Science Technology, University of Las
Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran
Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, dis-
tribution, and reproduction in any medium, provided the original work is properly cited.

reticulo-omasal transit, lesions in the mucosa of the reticulum
and alterations in ruminal fermentation, absorption or mobility
(Gutierrez et al. 1998), as well as ruminitis (Hailat et al. 1998).
Although it seems that goats could manifest a greater appetite
for indigestible materials (Gutierrez et al. 1998), some authors
have reported a higher incidence in sheep, despite their
more selective feeding behaviour (Baillie and Anzuino 2006;
Mozaffari 2009; Semieka 2010; Fromsa and Mohammed 2011).
Also, this feeding behaviour would explain why ropes, plastics
and threads are more frequently observed in goats (Gutierrez
et al. 1998; Kuotsu et al. 2019), while thick plant material that
ends up forming phytobezoars is more frequently found in
sheep (Misk et al. 1984).
These types of diseases are more frequent in developing
countries, triggered by conditions related to feeding manage-
ment and farm design. The ingestion of foreign bodies can
be associated with a phenomenon known as pica (Pugh and
Baird 2012), a disorder characterized by a craving and appetite
for non-edible substances − particularly for elements and trace
elements, such as salt, cobalt or phosphorus − which is some-
times observed in some states of nutritional deficiency (Fraser
and Bergeron 1991; Radostits et al. 2007). It is also observed
in diseases affecting the central nervous system (Gutierrez
et al. 1998), and can also be behavioural in origin (Pugh and
Baird 2012). The accumulation of indigestible material can
lead to the generation of a hard mass in the rumen (Geehan
et al. 2006), which could cause impaction (Kumar and
Sangwan 2017; Singh et al. 2019), the accumulation of gas
(Das and Behera 2011) and even death (Hailat et al. 1998).
Under these circumstances, rumenotomy is indicated.
Perioperative management
Ideally, the animal should fast for several hours before the pro-
cedure, in order to facilitate the surgical technique. Further-
more, fasting has the same beneficial effects as sedation
drugs. However, in an emergency, the fasting period should
not be enforced (Greene 2002; Hendrickson and Baird 2013)
Recent studies suggest that the use of perioperative non-
steroidal anti-inflammatory drugs, such as flunixin meglumine
or meloxicam, should be considered (Callan and Applegate
2017) even up to 7 days after the intervention (Das and
Behera 2011).
Because rumenotomy is a non-aseptic procedure, broad-
spectrum antibiotics such as oxytetracycline (Saidu et al.
2020), penicillin (Haven et al. 1992; Hayder 2004; Geehan
et al. 2006) ampicillin or ceftiofur (Callan and Applegate
2017) should be administered. Some authors have reported
that the prophylactic use of penicillin significantly reduces
the incidence of abscess formation after a rumenotomy. They
also demonstrated that an initial dose of antibiotic at the
time of surgery was all that was needed, as continuing the
therapy for several days after the surgery did not significantly
decrease the incidence of abscesses or the rate of infection
(Haven et al. 1992). Other concurrent diseases such as perito-
nitis, pericarditis and ruminal acidosis, among others, should
also be treated (Niehaus 2008; Callan and Applegate 2017). In
certain cases, some authors recommend fluid therapy prior to
the surgical procedure (Saidu et al. 2016; Dharmaceelan et al.
JOURNAL OF APPLIED ANIMAL RESEARCH 105
2017) and/or during surgery (Das and Behera 2011; Saidu
et al. 2016).
In clinical practice, general anesthesia in small ruminants is
challenging (Ghurashi et al. 2009). A combination of drugs for
the induction of anesthesia is usually the best option (Udegbu-
nam and Adetunji 2007). Side effects such as arousal during
induction or recovery, or increased muscle tone and salivation,
are generally counteracted with the use of sedatives such as
xylazine, acepromazine and diazepam (Udegbunam and Ade-
tunji 2007; Saidu et al. 2016). Some protocols recommend
prior sedation of the animals. For this effect, a dose of 0.15
mL of 2% xylazine per 15 kg − the equivalent of 0.2 mg xylazine
per kg − is recommended, administered either intramuscularly
(Gutierrez et al. 1998) or subcutaneously (Saidu et al. 2020).
Other authors have recommended the intravenous adminis-
tration of pre-anesthetics drugs such as acepromazine (0.1
mg/kg) or ketamine (22 mg/kg) (Chávez García et al. 2018).
Another successful protocol is the combination of diazepam
and ketamine (Udegbunam et al. 2019). Diazepam is a potent
long-acting sedative that produces muscle relaxation with
low cardiovascular effects (Koshy et al. 2003), which in combi-
nation with ketamine, alleviates the cardiovascular effects of
the latter. However, this combination has been shown to
produce short-term anesthesia and inadequate analgesia in
goats (Ghurashi et al. 2009).
Callan and Applegate (2017) even reported that the pro-
cedure should rarely be performed with sedation, opting
instead to simply immobilize the standing animal with a
restraint halter. It is important to prevent any gas distension
of the rumen before surgery, using either a gastric tube or by
decompressing the rumen with a needle before making the
incision through the abdominal wall. Anesthesia and sedation
should only be avoided in those cases in which the anesthetic
and/or sedative drugs are contraindicated due to the metabolic
or medical condition of the patient (Das and Behera 2011).
Once the animal is sedated, a large surgical field is prepared
in the left paralumbar fossa, shaving the area to avoid contami-
nation with hair, especially in the case of woolly sheep or long-
haired goats. The animal is placed in right lateral decubitus pos-
ition and kept tied up on the operating table. Some authors
have performed this surgical technique with the animal stand-
ing up (Saidu et al. 2020). The use of a hinged table has also
been reported (Geehan et al. 2006). After placing the animal
in lateral decubitus position, the table is turned so that the
animal remains standing because it is tied to the table. This
technique seems not only more comfortable for the surgeon,
but also for the animal, and it is recommended to avoid post-
operative complications (adhesions, infections, etc.). Once the
entire surgical field is free of hair, it is washed with alcohol
and povidone-iodine (Chávez García et al. 2018) or chlorhexi-
dine (Saidu et al. 2016; Udegbunam et al. 2019) and povi-
done-iodine (Saidu et al. 2020).
Six different techniques have been described for performing
paralumbar fossa and abdominal wall anesthesia: infiltration
anesthesia, proximal paravertebral thoracolumbar anesthesia,
lumbar distal thoracolumbar anesthesia, segmental dorsolum-
bar epidural anesthesia, lumbar segmental epidural anesthesia
and subcutaneous thoracolumbar anesthesia (Tranquilli et al.
2007). The use of various analgesics has been reported, such
106 S. MARTIN ET AL.
as 2% mepivacaine (Gutierrez et al. 1998), bupivacaine (Saidu
et al. 2016) or 2% lidocaine (Abdel-hady et al. 2015; Dharmacee-
lan et al. 2017; Mousam et al. 2018; Saidu et al. 2020), for both
paravertebral nerve block (proximal or distal) or for inverted L
block (Das and Behera 2011; Edmondson 2016; Dharmaceelan
et al. 2017). However, it should be noted that even at 1%, lido-
caine can induce toxic effects in both goats and sheep (Das and
Behera 2011; Fubini and Ducharme 2016).
Vaccination of the animal using tetanus toxoid before
surgery (Dharmaceelan et al. 2017) or afterwards (Hayder
2004) has been reported to successfully prevent disease
related to the procedure. Surgical drapes are also used to
prevent contamination.
Surgical techniques*
Rumenotomy is considered a clean-contaminated surgical
technique. The rumen should be accessed by approaching
the left paralumbar fossa. A vertical incision is performed just
behind the last rib, and about three centimeters from the trans-
verse lumbar process (Dharmaceelan et al. 2017), just above the
dorsal sac of the rumen (Lozier and Niehaus 2016). The main
objective is to externalize the dorsal sac and secure the
rumen wall to the skin, in order to prevent contamination of
the abdominal cavity and muscle layers. A rumenotomy is per-
formed immediately after an exploratory laparotomy (Niehaus
2008; Ordoñez Medina 2014; Abdel-hady et al. 2015).
The different surgical techniques differ from each other
according to the method used to fasten the rumen, either to
the body wall or to the skin (Niehaus 2008). Surgery begins
with the incision of the skin. The subcutaneous layer − which
may vary in thickness depending on the age and amount of
adipose tissue − is then cut. Next, the oblique abdominal
muscles (external, internal and transverse) are approached and
then the peritoneum is located (Jennings 1989; Niehaus 2008).
Once the peritoneum is opened, the rumen is exteriorized,
trying to choose the less vascularized area (Gutierrez et al.
1998). The rumen must be fastened prior to making the incision.
Fixation using four holding sutures: In this technique, four
sutures are used to anchor the rumen to the skin at the
dorsal, ventral, cranial and caudal parts of the incision. The
main disadvantage is that there are many areas where the
ruminal content can leak into the abdominal cavity (Geehan
et al. 2006; Niehaus 2008).
Skin clamp technique: The rumen is clamped to the skin with
towel clamps at various locations around the incision (Niehaus
2008; Udegbunam et al. 2019).
Anchoring devices after exteriorization of the rumen: Different
elements have been used to anchor the rumen. Michael and
McKinley (1954) designed a rumenotomy ring formed by an
aluminium ring with a rubber ring adhered to its internal cir-
cumference. The idea is that the rumen could be trapped in
this rubber ring, shortening the surgery time by eliminating
the need to suture the rumen to the skin. A modification of
this ring was the Weingarth ring, designed to secure the
hooks without an interior rubber ring. In this technique, the
dorsal sac of the rumen is grasped dorsally and ventrally with
large non-squash forceps. An incision is then made in the
rumen ventrally, hooks are placed on the cut edge and
attached to the device. As the incision continues dorsally,
more hooks are applied to the ventral forceps (Lozier and
Niehaus 2016). Another similar device is the Gabel rumen
retractor, which has screws to attach the rumen to the
device, thus providing better contamination results and a
shorter surgery time (Dehghani and Ghadrdani 1995)
Fixation with cutaneous suture: This is the most commonly
used technique. The rumen is sutured to the skin in a continu-
ous inverted pattern known as a Connell or Cushing pattern,
which allows the rumen to be inverted. The edge of the skin
is inverted to form a continuous seal, preventing the passage
of ruminal content into the abdominal cavity (Dehghani and
Ghadrdani 1995). The recommended suture thread is size #1
USP silk (Dharmaceelan et al. 2017). This suture must be per-
formed in short runs with this Cushing pattern to create a
seal between the serosa of the rumen (without entering the
lumen of the organ) and the skin, but without the distance
between the stitches being too short. This can be avoided by
creating a bag effect. Some authors recommend attaching
the rumen to the muscle wall for safety reasons before attach-
ing it to the skin,. However, post-operative problems have been
reported using this method (Lozier and Niehaus 2016).
Dehghani and Ghadrdani (1995) compared these four tech-
niques with regard to procedure time, postoperative body temp-
erature and white blood cell count. The conclusions were that a
rumenotomy with cutaneous sutures required significantly more
time than the other 3 methods. On the other hand, the four-
suture fixation method produced a significantly higher body
temperature during the first four days after the intervention
and a significantly higher white blood cell count and neutro-
phil-lymphocyte ratio during this time, as compared to animals
on which any of the other three techniques was performed.
Ruminal mortise or shroud: This is a rubber device that has a
similar large flat surface on one side and an internal edge that
fixes it to the interior of the temporary ruminal fistula (Hen-
drickson and Baird 2013). It can also consist of plastic drapes
with an adhesive surface to adhere to the outside of the
patient or the patient’s drape. It has an internal hole attached
to a rubber ring that collapses, allowing it to be inserted
through the rumenotomy. Once inside the rumen, it will
expand and hold the cloth in place. This will prevent the
rumen contents from coming into contact with the surgical
site (Lozier and Niehaus 2016). This cover is sometimes made
of polyethylene (Adamu et al. 1993).
Fixation to the peritoneum: In this case, the main disadvan-
tage is that the union could be very weak, which would allow
the rumen to retract into the abdominal cavity. In addition, it
is easier for contamination of the musculature to occur
(Niehaus 2008).
Once the rumen is fixed, a vertical incision (approximately 15
cm) is made in the rumen wall, while attempting to avoid vas-
cularized areas (Gutierrez et al. 1998; Niehaus 2008; Udegbu-
nam et al. 2019). In order not to interfere with the sutures in
place, a 3 cm margin is left on the dorsal and ventral aspect
(Lozier and Niehaus 2016). The incision must be large enough
not only to allow entry of the surgeon’s hand and forearm,
but also to be able to remove material from within the
rumen. Occasionally, due to its size, the content must be
broken up manually before removal from the rumen (Gutierrez

et al. 1998). The reticulum, omasum and abomasum can be pal-
pated transruminally. The ruminoreticular fold, esophageal
orifice and omasal orifice should be palpated to detect any
injury. The ventral sac of the rumen should also be thoroughly
explored for foreign bodies. Although uncommon in small
ruminants, the reticulum should be explored for foreign
bodies, adhesions or abscesses (Lozier and Niehaus 2016).
It is recommended that, after removing the cause of the
problem, a certain amount (around 1 kg) of concentrate
or fibrous elements be left inside the rumen (Das and
Behera 2011).
After removing the foreign bodies and completing the
ruminal examination, the organ should be closed with 2 layers
of sutures. The first layer is sutured while the rumen is still
attached to the skin. Size #1 USP absorbable suture material
has been used for this purpose, although some authors have
used USP #2/0. The inverted Cushing suture pattern (Niehaus
2008; Das and Behera 2011) or the inverted Lembert suture
pattern (O’Connor 2005; Dharmaceelan et al. 2017; Udegbunam
et al. 2019) are recommended because they provide a sealed
closure that prevents leakage of the rumen content into the per-
itoneal cavity. After being thoroughly washed out, the rumen is
released from the skin and sewn back in an inverted pattern,
using absorbable suture #2 USP. Some authors state that the
second layer should be wide enough to sew the suture holes
that were created when the rumen was sutured to the skin
(Lozier and Niehaus 2016). Once the rumen is closed, it is
thoroughly washed again and cleaned of any debris before it
is released and allowed to return to the abdomen.
After this procedure, it is recommended to replace the
material, as it will become a clean surgery (Niehaus 2008).
The flank incision is closed in 3 layers with #2 or #3 USP absorb-
able suture material that closes the peritoneum and transverse
abdominal muscle together and the external and internal
abdominal oblique muscles together, using a simple continu-
ous suture pattern (Udegbunam et al. 2019). Some studies
have reported the use of a mattress suture pattern to close
the oblique muscles (Dharmaceelan et al. 2017). The skin is
closed with a non-absorbable #3 USP suture in a Ford interlock-
ing suture pattern with 2–3 interrupted sutures at the bottom
of the incision, which can be opened in the case of a seroma
or incisional abscess (Lozier and Niehaus 2016). This last
suture can also be performed with sterile cotton sutures (Dhar-
maceelan et al. 2017) or non-absorbable #2/0 USP sutures,
using a simple discontinuous pattern (Udegbunam et al. 2019).
Postoperative management. Complications
Some authors recommend a single dose of penicillin at the
time of surgery (Haven et al. 1992), while others have used
broad spectrum cephalosporins (10 mg/IV) accompanied by
200 ml of physiological saline with dextrose (Das and Behera
2011), and more recently, 20 mg/kg oxytetracycline (Udegbu-
nam et al. 2019). Still other authors add 200 ml of intravenous
lactated ringer, in addition to 1 ml of intravenous tramadol for 5
days (Dharmaceelan et al. 2017). A number of studies using
different antibiotic treatments, however, have found that anti-
biotic administration in the days after surgery does not
decrease the likelihood of abscesses (Lozier and Niehaus
JOURNAL OF APPLIED ANIMAL RESEARCH 107
2016). The surgical wound must be cleaned daily with povi-
done-iodine and the sutures are removed on the 10th day
(Dharmaceelan et al. 2017).
The most common complications of rumen surgery include
abscesses at the incision site and peritonitis. Another poten-
tial complication is the formation of abscesses between the
muscle and the skin, which is attributed to dehiscence of
the sutures placed between the muscle and the rumen to
provide additional anchoring after suturing the rumen to
the skin. If these sutures are placed between the body wall
and the rumen, they should ideally be removed once the
rumen is attached to the skin (Lozier and Niehaus 2016).
Serum levels of amyloid A could be used in advance as a bio-
marker for potential complications that may arise after this
surgery in goats (Saidu et al. 2016) In cattle, the probability
of post-operative complications from rumenotomies has
been estimated as between 5-15%, depending on the
general condition of the animal prior to surgery and concur-
rent diseases. Incisional infections, peritonitis, seromas and
regurgitations are the most common complications (Niehaus
2008; Hartnack et al. 2015).
A very important point when evaluating post-operative pain
and optimal pathophysiological responses is the type of suture
used (Desborough 2000; Oguntoye and Adetunji 2009; Olaifa
et al. 2009), since it will directly influence post-operative
tissue reactions and related inflammatory processes (Saidu
et al. 2016). It seems that the use of PGA-type (polyglycolic
acid) sutures produces a lesser inflammatory reaction as com-
pared to the use of catgut (Saidu et al. 2016).
To reduce pain during rumenotomy, both intraoperative
and post-operative (Udegbunam et al. 2019) observations
found that goats anesthetized with diazepam-ketamine, to
which a subanesthetic dose of ketamine was applied during
and before surgery, suffered less postoperative pain.
However, they continued to manifest intraoperative pain
(Udegbunam et al. 2019). Other authors defend that the diaze-
pam-bupivacaine combination is ideal to reduce the stress
caused by this technique in goats (Saidu et al. 2016).
Disclosure statement
No potential conflict of interest was reported by the author(s).
ORCID
Sergio Martin http://orcid.org/0000-0002-1757-6634
Adassa María López http://orcid.org/0000-0003-1877-8964
Manuel Morales http://orcid.org/0000-0003-2795-8924
María Teresa Tejedor-Junco http://orcid.org/0000-0003-2387-1426
Juan Alberto Corbera http://orcid.org/0000-0001-7812-2065
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See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/314236760

An Alternative Method for Rumenotomy Repair with One Layer Closure Using
the Fishing Line as a Suture Material

Article  in  Global Veterinaria · January 2017

DOI: 10.5829/idosi.gv.2017.116.119

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Global Veterinaria 18 (2): 116-119, 2017
ISSN 1992-6197
© IDOSI Publications, 2017
DOI: 10.5829/idosi.gv.2017.116.119

An Alternative Method for Rumenotomy Repair with One

Layer Closure Using the Fishing Line as a Suture Material

Mokhtar Benchohra

Department of Biomedicine, Institute of Veterinary Sciences,

Ibn-Khaldoun University, Tiaret (14000), Algeria

Abstract: In this surgical case of rumenotomy, rumen and abdominal wall sutures were performed using fishing
line only. Closure of abdominal wall incision was made with a single layer, including peritoneum, flank muscles
and skin. So, no complications occurred postoperatively and after sutures removal. However, the technique
could be subject to further improvement.

Key words: Rumenotomy sutures Fishing line Mass closure including skin

INTRODUCTION The decision was taken to perform a rumenotomy for

Rumenotomy is a common surgical technique
for many diseases in cattle, such as traumatic
reticuloperitonitis; overload and bloat; spoiled roughage
and impactions [1]. Routinely, a flank laparotomy incision
in cattle is closed in three layers; using chromic catgut no.
2 or 3 for muscular plans and nonabsorbable suture for
the skin [2].
The single layer or mass closure is the closure of all
layers of the abdominal wall (except the skin) as 1
structure. Many surgeons have tested fishing line (nylon
6/6) as suture material and approved its utility for
abdominal mass closure [3-5].
The veterinary surgeon must adapt to the challenging
conditions of the field such as emergency cases, or when
suture material is few or not available and when the owner
is unable to pay the cost of a heavy surgery. The present
report aims to describe a nonconventional method of
surgical repair after rumenotomy; with a tested, easily
available and cheap material.
Case Description: A 10-year-old 350kg native cow was
examined for recurrent digestive disorders. So, the cow
showed a mild but progressive traumatic reticulitis
symptoms. A metal detector was applied over the median
and lateral regions of the chest and abdomen to detect a
ferromagnetic foreign body; result was positive.
reticulum prospection and eventually removal the foreign
bodies. The cow was restrained in a standing position;
her right side against the wall and the surgical area of the
left flank was shaved and flushed with iodine (PVP 10%),
just before starting the operation.
At the beginning, flunixin meglumine 3mg/100kg
(Lhiflunex, Lhiza) was administered intravenously. Then,
local anesthesia lidocaine 2% (30ml of xylocaine, Astra
Zeneca) was instituted by line block; a flank incision of
16cm for laparotomy was made caudal and parallel to the
last rib (paracostal laparotomy), with intention to place the
incision closer to the reticulum.
The skin and the three muscular layers of the
abdominal wall (external oblique, internal oblique and the
transverse abdominal) and peritoneum were incised and
the rumen fixed, by stray sutures using a thick nylon line;
maintained by two assistants and pulled over the flank
incision. Rumen wall was incised longitudinally 20cm in
the vertical direction on the dorsal compartment; so,
reticulum was explored and several sharpness foreign
bodies were removed.
Suture material consisted only of fishing line (pure
polyamide 6/6); which was sterilized by soaking in 10%
iodine solution for 10minutes. The rumen incision was
closed by double line continuous inverting sutures
(Fig. 1) using fishing line no. 0 USP (ø = 0.34mm,
Nederland). A simple interrupted suture was performed,

Corresponding Author: Mokhtar Benchohra, Department of Veterinary Biomedicine, Institute of Veterinary Sciences,
Ibn-Khaldoun Tiaret University, BP 1 poste de l’université 14010 Tiaret, Algeria.

116
 Global Veterinaria, 18 (2): 116-119, 2017
Fig. 1: Rumen incision sutured by continuous inverting
Fig. 2: The fishing line crossing the edges of the wound
(abdominal wall and skin)
Fig. 3: Suture material : surgical needel, intramuscular
injection needle and fishing lines.
117
with fishing line no. 1 USP (ø = 0.45mm, Germany), for
peritoneum, flank muscles and skin; using a mass suture
method (Fig. 2) and knots were reinforced as three-throw.
An ordinary large curved needle was used for suturing
the rumen and the abdominal wall; however, for a better
handling, the line was passed through the skin using an
intramuscular injection needle (1.2x40 mm, Terumo,
Belgium) (Fig.3).
Antibiotic treatment was initiated with amoxicillin
(1.5g/100kg, Amoxoil, Syva) by intraperitoneal route;
continued for 8 successive postoperative days. For two
postoperative days, flunixin meglumine was administered
intravenously to reduce inflammatory pain. To prevent
further complications, the cow was kept on a restricted
diet for two weeks.
DISCUSSION
The surgical operation was achieved without
incident; except that it has taken little more time during
suture of the abdominal wall, because of the translucency
of the fishing line. All physiological functions were
regular immediately after the operation and the cow has
recovered its appetite. Given the precarious financial
situation of the owner; the choice was made to minimize
the total cost of the surgical operation by using fishing
line as an inexpensive suture material. We have used a
twice line for more secure the continuous suture of the
rumen, also, to reduce the mechanical irritation or
discomfort and to avoid disruption of organ contractions;
which can result from the use of a thicker line.
According to Hodges, the fishing line can be used in
most situations, even where an absorbable suture is more
traditionally used; it has been most commonly used for
mass closure of the abdomen; the strong thicker line is the
most recommended and is very effective with low rates of
wound dehiscence [4]. In human surgery, the mass
closure was performed for all layers of the abdominal wall,
except the skin for cosmetic reasons [4,6,7]; however, in
cattle surgery, the cosmetic aspect is of minor importance.
It is well known that postoperative wound
dehiscence could lead to an incisional hernia [8]; but, in
the abdomen flank area, there is no risk considering that
the upper parts of the abdominal cavity of a cow are not
subject to digestive organs pressure. However, the high
rumen pressure resulting from overfilling or bloat might
cause stitch opening if restricted diet was no followed.
Thus, for counteracting the decreases of the knot-holding
capacity of the fishing line we have resorted to a three-
throw knot for enough secure.
 Global Veterinaria, 18 (2): 116-119, 2017
Fig. 4: Stages of the wound healing:
A - 11-day postoperative: dry appearance of the
skin around the wound.
B - 21-day postoperative: formation of a necrotic
tissue in the upper part of the wound.
C - One month postoperative: a good healing.
118
During the 11 postoperative days, no complications
were observed; neither wound infection, nor sepsis. The
cow has shown a good health status and the wound was
in the process of healing. Wound contours palpation did
not cause pain, the edges remain firmly joined and knots
well tied, however, around the wound, the skin appeared
dry (Fig.4A). After wound assessment, five alternate
stitches were removed, until the end of the incision line.
The removal of the remaining six sutures was made at the
21th postoperative day. At that moment, skin remained
dry and the upper part of the wound presented necrosis
and was frailty (Fig. 4B). Necrosis was may be due to two
main reasons; the first one would be the wound edges
strangulation by over-tightening the knots. In the case
where excessive tension was applied, tissue will become
ischemic and develop necrosis; which leads to delay
wound healing [2,9]. Good perfusion of the wound is an
essential factor in healing [10]. The second reason, being
the skin reaction to a foreign body; in fact, according to
our previous experience with fishing line use, in skin
closure, we notice that skin reaction begins around the
tenth postoperative day if the stitch is not removed. Thus,
we have removed sutures partly in order to limit the skin
reaction; once the knot has been pulled out, the wound
heals uneventfully [4]. Effectively, that is what we have
seen during the following week after the removal of all
stitches (Fig.4C).
Besides that, undernourishment to which the cow has
been subjected, particularly, in amino acids, vitamins and
minerals, may be responsible for skin disorders and
delayed wound healing [11,12].
Recent works comparing suture materials has tended
to show the advantages of non-absorbable material over
catgut and in consequence, there has been a marked
swing towards the use of this material in abdominal
closure; therefore, several reports in human surgery had
shown that many operations can be performed entirely
with fishing line [4-6,13]. Surgeons who have widely used
this material describe it as a tried and tested alternative to
commercial sutures when cost and availability limit their
use [3-5]. In fact, the cost of the fishing line used in our
case was about 40 times lower than commercial suture
material. Narasimharao et al. [13], who have widely resort
to the mass abdominal closure, including the skin, in
pediatric, describe it advantages as easy closure in
difficult cases; no wound dehiscence risk; no foreign
body left in the wound and a greatly reduced infection
rate, author recommend this technique as a routine. While
the surgeons have had assessed the efficiency and safety
of the fishing line as suture material and the method of
 Global Veterinaria, 18 (2): 116-119, 2017
abdominal mass closure for decades now, in human
medicine [4-6,13,14]; the use of this material and
method remains not well known by the veterinary
surgeons.
In conclusion, the abdominal mass closure with
appropriate fishing line seems an alternative for the
conventional method of laparotomy repair. However, the
technique might be subject to improvement as the need
arises. The fishing line appears to have real advantages,
in terms of cost and availability; and material sterilization
is quick and easy.
REFERENCES
1. Hendrickson, D.A. and A.N. Baird, 2013. Suture
materials and needles Techniques in Large Animal
Surgery. John Wiley & Sons 4th Ed., pp: 323.
2. Turner, A.S. and C.W. MclLwraith, 1989. Techniques
in large animal surgery. Lippincott Williams &Wilkins
2ndEd., pp: 373.
3. Longombe, A.O., A. Ralaimiarison and K.M. Lusi,
1993. The use of fishing nylon for surgery in rural
areas in North East Zaire. Trop. Doct., 23(4): 179-180.
4. Hodges, A.M., 2001. Fishing line: a valuable suture
material. Trop. Doct., 31(2): 98-99.
5. Pereira, E.A.C. and M.H. Cotton, 2006. Methods and
Devices: Using fishing line for suturing. Trop. Doct.,
36(2): 155-156.
119
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6. Bewes, P., 2000. Abdominal closure. Trop. Doct.,
30(1): 39-40.
7. Ceydeli, A., J. Rucinski and L. Wise, 2005. Finding
the best abdominal closure: an evidence-based
review of the literature. Curr. Surg., 62(2): 220-225.
8. Kingsnorth, A., 2006. The management of incisional
hernia: a review. Ann. R. Coll. Surg. Engl., 88: 252-260.
Doi: 10.1308/003588406X106324
9. Kudur, M.H., S.B. Pai, H. Sripathi and S. Prabhu, 2009.
Sutures and suturing techniques in skin closure.
Indian J. Dermatol. Venereol. Leprol., 75: 425-34.
10. DeLancey, J. and R. Hartman, 2008. Operations on the
abdominal wall glob. Libr. Women's Med. DOI
10.3843/GLOWM.10038
11. Asplund, J.M., 1994. Principles of protein nutrition
of ruminants Chap. 8: Amino acid and protein
metabolism in the whole body and individual tissues
of ruminants. CRC Press (Ed), Inc USA. pp: 155.
12. Haresign, W. and D.J.A. Cole, 1988. Recent
developments in ruminant nutrition - 2: Effect of
proteins on health of dairy cows. Butterworths (Ed)
London, pp: 184.
13. Narasimharao, K.L., H. Chatterjee and S. Parkash,
1983. Single layer abdominal wound closure in
children. Aust. N. Z. J. Surg., 53: 577-579.
14. Pollock, V., M.J. Greenali and M. Evans, 1979.
Single-layer mass closure of major laparotomies by
continuous suturing. J. R. Soc. Med., 72: 889-893.
 ILMU BEDAH KHUSUS VETERINER
“TEKNIK OPERASI GASTROTOMY DAN RUMENOTOMY”
(KELOMPOK 4 / KELAS A)
ANGGOTA :
NI MADE ADINDA ARYA
01 NINGRUM (1809511015)

NI MADE RITA
02 ADNYANI (1809511017)

KADEK LENI MARTHA DIANA

03 (1809511019)

04 PUTU DEVINDIA TRISHA

SUCIADA (1809511030)
 LATAR Anjing dan kucing merupakan hewan kesayangan yang banyak
BELAKANG digemari oleh masyarakat. Banyak diantara hewan kesayangan tersebut
mengalami gangguan penyakit sehingga sehingga harus menjalani
pembedahan. Salah satunya pembedahan di saluran pencernaan
seperti pada gastrium.
Kasus gastrointestinal pada hewan kesayangan (kucing dan
dan anjing) yang mengharuskan dilakukannya gastrotomi adalah kasus
(pengangkatan benda asing). Gastrotomy dilakukan pada hewan non
ruminansia, sedangkan hewan ruminansia misalnya pada sapi
dilakukan Rumenotomy.
 TERMINOLOGI
Rumenotomy merupakan tindakan bedah yang dilakukan untuk
membuka rumen dari ruminansia. Tujuan dari dibukanya rumen usus
adalah untuk mengangkat benda asing yang ada didalam rumen. Selain
RUMENOTOMY benda asing, tindakan bedah ini juga dilakukan untuk mengatasi
kembung atau bloat, dan juga untuk mengatasi adanya traumatik pada
lambung (rumen, retikulum, omasum ataupun abomasum).

Gastrotomi adalah tindakan pembedahan dengan melakukan

incisi pada dinding lambung sehingga terlihat lumennya.
GASTROTOMY
Gastrotomy merupakan suatu pembedahan dengan penyayatan
untuk menghasilkan atau memberikan pemeriksaan yang akurat
dalam lambung.
 INDIKASI
GASTROTOMY RUMENOTOMY

Indikasi untuk operasi pada rumen meliputi trauma

Indikasi utama dilakukannya pembedahan
reticuloperitonitis, rumen dan adanya benda asing di
gastrotomi adalah untuk mengeluarkan benda asing
rumen, frothy boat, vagal indigesti, kelebihan
(terutama pada hewan anjing dan kucing),
gandum (grain overload), toxin ingestion dan
memeriksa mukosa lambung yang luka (ulser),
chronic reoccuring bloat. Rumenotommy eksplorasi
neoplasma atau hypertropi, serta untuk tujuan
dapat dilakukan untuk mengambil benda asing yang
biopsi dan diagnosis
tertelan.
GASTROTOMY
ANASTESI PENTING!!!

Ketika digunakan sebagai obat tunggal,

ketamin tidak menghasilkan relaksasi
muskulus skeletal yang baik, dan dapat
Dosis yang dianjurkan untuk
anjing dan kucing 10-20 mencapai recovery dengan segara dan
01 KETAMIN
mg/kg BB secara IM biasanya dapat menyebabkan konvulsi
pada anjing dan terkadang kucing. Untuk
menghindari efek tersebut, banyak dokter
hewan yang menggunakan ketamin
bersama-sama dengan diazepam,
Dosis untuk anjing 1-2 mg/kg
02 XYLAZINE BB secara IM acepromazin, xylazine thiobarbiturat atau
anastesi inhalasi.
 ANASTESI LANJUTAN…

RUMENOTOMY

Anastesi yang dapat diberikan dengan cara line • Ruminansia kecil: obat pra-anestesi
block, inverted block, atau paravertebral seperti acepromazine (0,1 mg/kg) atau
block. Anastesi diberikan secara regional ketamin (22 mg/kg) secara IV

dengan menggunakan teknik paravertebral • Lidocaine HCl sebanyak 20 ml pada sapi

block dan L-block. Anastesi ini dimaksudkan menggunakan metode farqurhason

dengan processus transversus sebagai
untuk mematikan rasa di daerah flank.
penanda.
 1. PERSIAPAN ALAT DAN BAHAN

ALAT
Beberapa alat yang termasuk dalam prosedur operasi,
yaitu: meja operasi, spuit, scapel, needle, needle
PRA-OPERASI holder, tampon, stetoskop, sarung tangan, kain drape,
lampu operasi, pinset anatomis, gunting lurus dan
bengkok, thermometer, Alli’s Forceps serta arteri klem
anatomi
.

BAHAN
Kain drape, tampon, alkohol 70%, aquades, kasa steril, benang
jahit absorbable dan non-absorbable, perban, iodium tincture 3%,
gloves, masker, spuite 3 ml, dan cairan infus (NaCl fisiologis 10-
20 ml/kgBB, subkutan) jika diperlukan; lalu obat yang perlu
dipersiapkan adalah premedikasi (Atrofin sulfat), anestesi
(ketamine HCl 10 %, xylazine HCl 2 %), serta antibiotik post
operasi.
 2. PERSIAPAN PASIEN (HEWAN)

Lakukan anamnesa dan pemeriksaan fisik (pengisian

signalemen, pengukuran berat badan, umur, pulsus,
frekuensi napas, suhu tubuh, dan pemeriksaan sistem
PRA-OPERASI tubuh lainnya (digestivus, respirasi, sirkulasi, saraf, dan
reproduksi) dan jika perlu dapat dilakukan pemeriksaan
laboratorium untuk memastikan bahwa sistem dalam
tubuh berfungsi secara normal. Hewan yang sehat terlebih
dahulu dipuasakan, yaitu selama 12 jam untuk puasa
makan dan 6 jam untuk puasa minum. Hewan yang akan
di operasi selanjutnya akan diberikan premedikasi dan site
operasi, lalu pemasangan IV cateter, infus, dan anestesi.
.
 3. PERSIAPAN OPERATOR

Operator harus memiliki kompetensi yang baik dalam

melakukan operasi agar operasi berjalan dengan lancar.
Kompetensi tersebut meliputi pemahaman prosedur
PRA-OPERASI operasi, seperti :
.
1. Siap fisik dan mental
2. Personal hygiene yang meliputi kondisi sehat serta melakukan
pembersihan diri (mencuci tangan dengan sabun antiseptik, memakai
baju operasi, glove, masker, dan penutup kepala),
3. Mampu memprediksi hal-hal yang akan terjadi atau dapat
menggambarkan bahaya yang mungkin timbul pada pelaksanaan
operasi serta memperkirakan hasil operasi (prognosis),
4. Terampil
 TEKNIK
OPERASI
GASTROTOMY
TEKNIK OPERASI GASTROTOMY

Setelah dilakukan pemeriksaan fisik dan radiograph,

1 melakukan evaluasi terhadap keseimbangan
elektrolitnya

Selanjutnya hewan diberikan anestesi umum dan

2 ditempatkan pada posisi dorsal recumbency

Setelah itu melakukan incisi kulit pada ventral midline

3 abdominal dari xipoid sampai pubis.

Incisi dilanjutkan pada linea alba dan peritonium

4 sehingga rongga abdominal terbuka.
TEKNIK OPERASI GASTROTOMY

Dinding abdominal dikuakkan dengan retraktor

sehingga gastrointestinal terlihat. Lambung dikeluarkan
5 dengan membuat jahitan stay suture yang bertujuan
untuk memegang dinding lambung

Selanjutnya melakukan incisi pada dinding lambung

6 yang sedikit pembuluh darahnya (bagian curvatura
mayor)

Incisi dibuat agar tidak dekat dengan pilorus dan incisi

7 dilebarkan dengan gunting.

Setelah dilakukan tindakan pada lambung

(mengeluarkan benda asing, biopsi), segera dilakukan
8 penutupan pada serosa muskularis, dan submukosa
sebagai lapis pertama dengan pola jahitan cushing
atau simple interrupted selanjutnya dijahit dengan pola
lembert atau cushing.
TEKNIK OPERASI GASTROTOMY

Lambung dimasukkan ke dalam rongga perut dan

9
dilakukan penutupan dinding perut.

Pada bagian peritonium, linea alba, dan subkutan

10 dijahit dengan benang absorbable serta kulit dijahit
dengan benang nonabsorbable.
GAMBARAN TEKNIK OPERASI GASTROTOMY

1 2 3 4

8 7 6 5
 TEKNIK
OPERASI
RUMENOTOMY
 TEKNIK OPERASI RUMENOTOMY
1. Sebelum operasi dilakukan,
bagian yang akan dioperasi
dicukur (daerah flank), setelah
itu diolesi alkohol.
2. Persiapan alat – alat operasi juga
dilakukan. Perbedaan alat yang
dipakai adalah pemakaian shroud
atau plastik untuk rumen. Setelah itu
baru hewan diberi cairan anastesi.
3. Anastesi yang dapat diberikan
dengan cara line block, inverted
block, atau paravertebral block
4. Pada kasus rumenotomi biasanya
anastesika diberikan secara regional
dengan menggunakan teknik
paravertebral block dan L – block.
Anastesi ini dimaksudkan untuk
mematikan rasa di daerah flank.
5. Teknik ini mempunyai beberapa
keuntungan seperti daerah yang
Online Doctor
teranastesi cukup besar, menggunakan
anastesi yang lebih sedikit dibanding
anastesi lain dan tidak mengakibatkan
distorsi jaringan.
6. Untuk memperoleh hasil anastesi
yang sesuai, teknik ini
membutuhkan keahlian serta waktu
untuk melakukannya dan peletakan
agen anastesi haruslah tepat.
 TEKNIK OPERASI RUMENOTOMY
10. Struktur lain dari dinding
7. Anastetika yang digunakan adalah
abdomen yang harus dihindari saat
Lidocain HCl. Pemberian Lidocaine
insisi adalah nervus dan pembuluh
HCL dilakukan menggunakan
darah. Jika ada pembuluh darah
metode farqurhason dengan
harus di ligasi terlebih dahulu.
processus transversus sebagai
Rumen ditarik ke luar dengan
penanda.
bantuan allies forcep atau dua buah
.
jahitan yang kuat.
8.Tiap tempat diberikan injeksi 11. Incisi rumen dibuat diantara kedua
Lidocaine HCl sebanyak 20 ml. Setelah jahitan setelah cavum abdomen
sekitar 5 – 10 menit kemudian, Online Doctor ditutup. Setelah rumen dibuka
dilakukan tes untuk mengetahui dimasukkan rumen shroud untuk
apakah daerah operasi sudah mencegah kontaminasi kemudian isi
teranastesi sempuna atau belum, rumen dikeluarkan sehingga rumen
dengan menggunakan Allis forceps dapat dieksplorasi untuk mencari
dilakukan jepitan – jepitan daerah yang benda asing.
dianastesi tersebut.
. 12. Tepi rumen yang diincisi
dibersihkan dan dijahit dengan tipe
jahitan sederhana menerus dilanjutkan
9. Setelah hewan teranastesi, dilakukan incisi sepanjang 12 cm dengan tipe jahitan kontinous lambert
pada kulit dimulai dari kira – kira 10 cm di bawah prosesus dengan menggunakan benang catgut
transversus dari vertebrae lumbaris pertengahan flank. chromic.
 TEKNIK OPERASI RUMENOTOMY

13. Peritoneum dan muskulus dijahit

15. Kulit dijahit dengan tipe jahitan
secara terpisah dengan tipe jahitan
sederhana tunggal menggunakan
sederhana tunggal menggunakan
benang katun.
benang catgut chromic.
.
.

Online Doctor

14. Sub kutan dijahit dengan pola

jahitan sederhana menerus 16. Iodium tincture dioleskan pada
menggunakan benang catgut plain. luka.
.
GAMBARAN TEKNIK OPERASI RUMENOTOMY

1 2 3 4

8 7 6 5
GAMBARAN TEKNIK OPERASI RUMENOTOMY

9 10

12 11
 GASTROTOMY
Segera setelah penutupan dinding abdomen dilakukan penyuntikan
Ampicillin 10 % dengan dosis 10-20 mg/kg BB secara intramuskuler untuk
menghindari adanya infeksi sekunder

Selama hewan masih teranastesi, dilakukan infus RD 5 % untuk mengganti

cairan yang hilang dan untuk koreksi keseimbangan elektrolit secara
intravena. Luka bekas operasi diolesi salep bioplasenton

Selain itu juga dilakukan monitoring terhadap denyut jantung, pernafasan dan
temperatur tubuh. Untuk mencegah keadaan hipotermi dapat dilakukan dengan
menggunakan lampu penghangat, selimut atau infus yang dihangatkan.

Setelah hewan dioperasi ditempatkan pada tempat yang

kering dan bersih, luka operasi dijaga kebersihannya dan
pemeriksaan dilakukan selama 4 – 6 hari berturut – turut.
 RUMENOTOMY
Terapi pasca operasi yang diberikan adalah injeksi ampicilin 1,6 ml. Injeksi diberikan secara
intramuskuler 2 kali sehari. Pengobatan antibiotik ditujukan untuk mencegah terjadinya
infeksi baik yang diakibatkan oleh kurang terjaganya sterilitas operasi maupun akibat
masuknya agen penyakit atau bakteri melalui celah luka pada saat proses penyembuhan.

Ampicillin merupakan salah satu obat semi sintetik Penicillin yang paling penting,
mempunyai aktifitas bakterisid, merupakan antibiotik berspektrum luas, dan aktif
melawan sejumlah besar organisme gram positif dan negatif

Ampicillin bekerja dengan cara menghambat sintesa dinding sel bakteri. Ampicillin
didistribusikan ke seluruh jaringan tubuh dan terpusat dalam hati dan ginjal. Dosis
Ampicillin pada domba 10-20 mg/kg BB secara per oral, dan 5-10 mg/kg BB
secara parenteral
THANK YOU