Key gastrointestinal surgeries: Omentalization - Veterinary Medicine
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Key gastrointestinal surgeries: Omentalization
This easy-to-do procedure can be used to seal incision sites, help reconstruct infected skin wounds,or create a physiologic drain. Here's how to place an omental patch in the gastrointestinal tract.


VETERINARY MEDICINE


COMPLICATIONS

Complications arising from omental patch placement or omental pedicle grafting are rare and fairly inconsequential. The most common complication is partial necrosis of the omentum, which is usually the result of excessive tension or strangulation of a pedicle.2,4 Excessive or improper handling of the omentum during surgery may also lead to desiccation. Desiccation can be prevented by frequently moistening the omentum during the procedure or by keeping it wrapped in saline-soaked laparotomy pads. Intestinal entrapment by omental adhesions or tears can cause strangulation or torsion of the bowel in animals that have not undergone omentalization; a similar problem could occur after omental patch placement.14,15 We know of two animals that developed intestinal obstruction after omentum, which had been wrapped 360 degrees around their intestines, hypertrophied. Consequently, encircling the intestines with a single flap of omentum is not recommended.

Erik Anderson, BS
Karen M. Tobias, DVM, MS, DACVS
Department of Small Animal Clinical Sciences
College of Veterinary Medicine
The University of Tennessee
Knoxville, TN 37996-4544

REFERENCES

1. Williams JM, Niles JD. Use of omentum as a physiologic drain for the treatment of chylothorax in a dog. Vet Surg 1999;28:61-65.

2. Hosgood G. The omentum—the forgotten organ: physiology and potential surgical applications in dogs and cats. Comp Contin Educ Pract Vet 1990;12:45-51.

3. Kirby BM. Peritoneum and peritoneal cavity. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia, Pa: WB Saunders Co, 2003;414-445.

4. Heller J, Hunt GB. Clinical applications of the omentum in dogs and cats. Aust Vet Practit 2002;32:66-73.

5. White RA, Williams JM. Intracapsular prostatic omentalization: a new technique for management of prostatic abscesses in dogs. Vet Surg 1995;24:390-395.

6. Lascelles BD, White RA. Combined omental pedicle grafts and thoracodorsal axial pattern flaps for the reconstruction of chronic, nonhealing axillary wounds in cats. Vet Surg 2001;30:380-385.

7. McLachlin AD, Denton DW. Omental protection of intestinal anastomoses. Am J Surg 1973;125:134-140.

8. Campbell BG. Omentalization of a nonresectable uterine stump abscess in a dog. J Am Vet Med Assoc 2004;224:1799-1803.

9. Hoelzler MG, Bellah JR, Donofro MC. Omentalization of cystic sublumbar lymph node metastases for long-term palliation of tenesmus and dysuria in a dog with anal sac adenocarcinoma. J Am Vet Med Assoc 2001;219:1729-1731.

10. LaFond E, Weirich WE, Salisbury SK. Omentalization of the thorax for treatment of idiopathic chylothorax with constrictive pleuritis in a cat. J Am Anim Hosp Assoc 2002;38:74-78.

11. Smith BA, Hosgood G, Hedlund CS. Omental pedicle used to manage a large dorsal wound in a dog. J Small Anim Pract 1995;36:267-270.

12. Ross WE, Pardo AD. Evaluation of an omental pedicle extension technique in the dog. Vet Surg 1993;22:37-43.

13. Evans HE, deLahunta A, Miller ME. Guide to the dissection of the dog. 5th ed. Philadelphia, Pa: WB Saunders Co, 2000;201-202.

14. Rawlings CA. When and how to quickly use the omentum in surgery, in Proceedings. North Am Vet Conf Small Anim Exotics Ed 2004;18;1190-1191.

15. Hosgood G, Bunge M, Dorfman M. Jejunal incarceration by an omental tear in a dog. J Am Vet Med Assoc 1992;200:947-950.


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