Trocarization in Small & large Animals-1.pptx

*Trocarization*

*Trocarization* refers to the use of a trocar, a surgical instrument, to puncture a body cavity for various medical purposes. In the context of equine medicine, trocarization is used for decompression in cases of colic and large intestinal gas distension. It allows for rapid controlled decompression of colonic or cecal tympany, permitting improvement of both ventilation and intraabdominal pressure

The procedure involves the insertion of a trocar into the large colon or cecum to resolve gas distension and accompanying increased intraabdominal pressure. It's important to note that trocarization is not a substitute for surgery in severely gas-distended painful horses exhibiting signs of colic that require surgery
Complications following transcutaneous cecal trocarization may include a decrease in cecal motility over time, possibly due to local inflammation caused by the puncture. However, large intestinal trocarization could be considered for equids with colic and large intestinal gas distension, and more than one trocarization procedure was reported in some cases

In summary, trocarization is a medical procedure used in equine medicine for decompression in cases of colic and large intestinal gas distension, but it's not a substitute for surgery in severe cases. It's important to consider potential complications and the specific conditions under which it may be appropriate.

1. Trocarization in Small & large Animals

2. What is Trocarization It is a medical procedure which make use of trocar ( trochar ) cannula for performing different minimal invasive surgeries. Trocar may be metal or plastic made, having a pointed or tapered tips or pen shaped some time called as obstructor Cannula / Seleeve  It a rigid hollow tube/cylinder and is pathway into a cavity often covered by a seal

3. Trocar is a "three-pointed/sided intrument Cutting trocar "dilating-tip“- it is a sharp which contain blade usually used for minimal cutting or incisions causes high risk of hernia Bladless trocar - it is a blunt ,offers greater patient safety and less damge of tissues but require more force to insert Optical trocar - it is ablunt and fitted with tinny viewing window to observe the tissue sites insrtion .Originally, doctors used trocars to relieve pressure developed by fluids ( edema ) or gases ( bloating ). Types of trocar canula

4. Different forms of Trocar Cannula Cat and dogs Equine plastic Sheep & goat 3D laproscopic Trocars

5. How to perform trocarization technique Clip hair,Sterilize and do antiseptic skin preparation. Subcutaneous infiltration of local anesthetic if not performed under general anesthesia. Skin incision at the access location. Puncture and advancement of the trocar system into the desired cavity, organ or fluid collection

6. The trocar should be palmed so that only 1 cm of the sharp tip protrudes beyond the operator's fingers. Following shallow penetration to seat the trocar at a 90° angle in the fascia-peritoneum anatomical funnel created where skin, deep fascia and peritoneum meet, the trocar is upturned to approximately 60°. Angle of trocarization The trocar puncture is sealed with a plastic plug called a trocar button

7. Laproscopic surgery Veterinary Use Insufflation ( ie -to ventilate or oxygenate the patient and to maintain the anesthetic condition) Embalming of Dead body Thorecocentesis in cat Application of Trocarization

8. Laproscopic surgery Aligator trocar Trocars are used in laproscopy to avoid large damge of tissue and to observe the internal organs properly such trocars facilitate cameras , alligators , tube , electrocautery macine to perform different invasive surgical protocols Cameras based trocar

9. Trocars are used in medicine to access and drain collections of fluid such as in a patient with  hydrothorax  or  ascites . Trocars are designed for placement through the chest and abdominal walls during  thoracoscopic  and laparoscopic surgery Trocars also allow passive evacuation of excess gas or fluid from organs within the body Veterinary Use GDV IN DOG Hydrothorax

10. Pasing stomach tube is best treatment for grassy bloat but in a few cases of  ruminal tympany   where tube is not workable a wide-bore trocar may be passed through the left flank para lumber fossa region of ruman to escape gas as hissing sound Some clinicians perform sutures circumferencly over skin hole to creat rumen fistula as to avoid the recuring future bloat Severe tympany ( Abedomenocentesis ) Trocar cannula is used in middle of flank Fire along with gas expulsion

11. It foamy fluid and gaseous condition seen in ruminants usllay after the ingestion of protein high rich concentrates & spring grasses such problems are tackled through pouring antifoaming agents through trocar cannula or by stomach tube Frothy bloat

12. Severe abdominal distention in horse For detailed Rectal palpation ,Per cutanenous cecal trocarization is necessary to perform To Release gas due to colon impaction a operator should be positioned on the right side and over the thorax area of horse because there is risk of kicking from hind limb Horse is uncofortable

13. To emeregency Relieve from urolithiosis problem like wise urethral caLculi or nephron stones/ calculi Catheterization through trocar Bladder puncture through trocar Bladder puncture ( Cystocentesis )

14. In dogs, a similar procedure is often performed for patients presenting with  gastric dilatation volvulus  in which a wide-bore trocar is passed through the skin into the stomach to immediately decompress the stomach. Depending on the severity of clinical signs on presentation, this is often performed after pain management has been administered but prior to  general anaesthesia . Gastric dilation volvulus in dog - GDV

15. Hysterctomy & Endometritis u terus Hysterctomy is the surgically removal of uterus Endometritis is the inflamation of endometrial layer of uterus that is due infection , cysts formation or pymetria or hormonal disturbances

16. Salpinectomy in cat Laproscopic surgery of removal of oviducts of cat commonly obsereved due to hormonal inbalance or cysts formation

17. Gastropexy in dog In dogs mostly GERD(Gastro esophageal reflux disease) is obseerved in which gastric acid is flow back towards esopahagus hence causing irritation over there Gastropexy is surgical treatment by anatomical repositioning of the stomach and spleen  Depending on the severity, partial  gastrectomy  

18. Splenectomy in cat Spleen cancer Splenectomy  may be indicated if the relevant tissues have necrosed due to ischemia caused by torsion/avulsion of the supplying vasculature

19. Embalming Trocars are also used near the end of the  embalming  process (animal cadavers) to provide drainage of bodily fluids by IV and organs after the vascular replacement of blood with embalming chemicals known as aspiration but an electric aspirator can also be use

20. Medical complication Insertion of each trocar carries the risk for a life threatening injury Peritonitis - intra-abdominal trocar insertion Heamorrhage - injury to large blood vessels Local subcutanenous abcess

21. Precautions Today, surgical trocars are most commonly a single patient use instrument Appropriate training and skills is important to properly insert the trocar with guided force known as a “controlled jab” The surgeon can see the internal structures of the body easily Potential for damage to internal organs is decreased by inflating the abdominal cavity with  carbon dioxide  gas before trocar insertion, to hold the body wall away from the organs. Benefits of Trocarization

22. Risk Factors for trocar insertion Prior abdominal surgery Young onces Small, thin body type Alterations in abdomen skin due to multiple pregnancies Atrophied abdominal musculature

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