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This Concept Map, created with IHMC CmapTools, has information related to: Right Sided Exploratory Laparotomy, A Sharp incision is made midway between the last rib and tubercoxae about 20cm long. Use a haemostat to ligate and bleeding vessels. Step 2 Incise the cutaneous trunci muscle sharply (we cut through ours with the skin), Right Side Exploratory Laparotomy Of 'Catapult' Pre- Op Sedation and Induction, Site preparation consists of Clipping, Procedure Step 1 A Sharp incision is made midway between the last rib and tubercoxae about 20cm long. Use a haemostat to ligate and bleeding vessels., Right Side Exploratory Laparotomy Of 'Catapult' Post-Op Day 1, Pull the omentum cranially to locate the abomasum, duodenum and differentiate the lesser and greater omentum NB: SITE FOR OMENTOPEXY- IN GREATER OMENTUM JUST ADJACENT TO THE PYLORIC PART OF THE ABOMASUM Step 7 Palpate caudally and exteriorise the caecum and small intestines. Rotate the caecum and omentum 180 degrees to view the spiral colon Replace all the organs starting cranial portion of the jejenum and then the distal ileum NB: moisten the organs with saline every few minutes, Right Side Exploratory Laparotomy Of 'Catapult' Pre- Op Physical Exam (ASA Grade-1), Palpate caudally and exteriorise the caecum and small intestines. Rotate the caecum and omentum 180 degrees to view the spiral colon Replace all the organs starting cranial portion of the jejenum and then the distal ileum NB: moisten the organs with saline every few minutes Step 8 Closure: 1. First close the transverse abdominus in a simple continuous fashion using 0 PDS ensuring not to incude any organs or omentum. 2. Close the Internal and external adnominal oblique muscles together using 0 PDS in a simple continuous. Try to incorprate the fascia because it has more holding strength. 3. Finally, Close the skin and trunci muscle using ford interlocking pattern with 1 prolene for 3/4 of the incision. The caudal 1/4 closed with simple interrupted sutures to allow for a drain to be put in if needed., Sharply incise the external and internal abdominal oblique muscles. The muscles areaponeurotic at the ventral part of the abdominal wall so cut all the way through the fascia, where possible, and then extend the incision Step 4 Tent the transverse abdominus muscle and make a nick with the scissors. Insert a finger and feel for any adhesions. Once none are felt extend the incision, Incise the cutaneous trunci muscle sharply (we cut through ours with the skin) Step 3 Sharply incise the external and internal abdominal oblique muscles. The muscles areaponeurotic at the ventral part of the abdominal wall so cut all the way through the fascia, where possible, and then extend the incision, Site preparation consists of Scrubs, Site preparation consists of Draping, Right Side Exploratory Laparotomy Of 'Catapult' Drugs Table, Right Side Exploratory Laparotomy Of 'Catapult' Post-Op Day 3, Right Side Exploratory Laparotomy Of 'Catapult' Intra- Op Procedure, Right Side Exploratory Laparotomy Of 'Catapult' Pre- Op Lumbosacral epidural, Immediately post op 45mins 3:24pm T:35.3C HR:88bpm RR:48bpm, Right Side Exploratory Laparotomy Of 'Catapult' Post-Op Possible Complications, Tent the transverse abdominus muscle and make a nick with the scissors. Insert a finger and feel for any adhesions. Once none are felt extend the incision Step 5 Palpate insitu and feel for any abnormalities. You can also feel the organs which cannot be exteriorised now (refer to table), Palpate insitu and feel for any abnormalities. You can also feel the organs which cannot be exteriorised now (refer to table) Step 6 Pull the omentum cranially to locate the abomasum, duodenum and differentiate the lesser and greater omentum NB: SITE FOR OMENTOPEXY- IN GREATER OMENTUM JUST ADJACENT TO THE PYLORIC PART OF THE ABOMASUM