10 tips to becoming a well-oiled surgical machine

Author: Kelsie Crawford

New to animal surgery? Years of experience? Regardless of your comfort and experience with surgery, you’ll want to read this. We’ve put together the top ten tips you’ll need to help you become a surgical machine.

1. Have a plan and know your space

This is the most important tip of all. In a human operating room or even a veterinary one there are at least two people in the space responsible for the animal, anesthetics, surgical procedure and recovery and likely another person available to grab something from another space if needed. In research related spaces, YOU are responsible for all parts of the process so having a flow planned and knowledge of your space is key to surgical success.  

Know where all the needed things are. Know where all the machines you need are and how they work. Know how to use and troubleshoot the anesthetic machine.  

In general a rodent surgery space should have the following components: animal preparation area; surgeon preparation area, a surgical area and a recovery area set up in a way that promotes easy use of the space. 

Basic supplies should include a sterile instrument pack, sterile supplies (drapes, gauze, gloves, etc.), disinfectant and a glass bead sterilizer, a hot water blanket or heat pad, fluids and necessary medications and a supply of needles and syringes.  

 2. Animal prep

It is important that the subjects are properly identified (strain, sex, age, etc.). Perform a physical examination to determine if the animal is healthy and active.  

Apply ophthalmic ointment to the eyes directly after induction to prevent corneal drying.  

Administer fluids and analgesia pre-operatively.  

3. Skin prep

Preparation should be performed in a separate location than where the surgery will be performed. Always prepare an area approximately twice the surgical area you will need. A gauze sponge or Q-tips can be used for scrubbing, which should be done from the center outward (clean to dirty). Avoid wetting large areas of fur with alcohol because of the potential to induce hypothermia. 

 4. Temperature control 

Rodents tend to lose heat rapidly and should always be kept warm preferably with a hot water blanket or heat pad. Loss of heat can significantly prolong the duration of anesthetic, which in turn increases the risk of complications.  

The decision to drape depends on the surgery being completed. Short procedures may not need draping, however, drapes help to maintain a sterile surgical field, help keep the tips of instruments within the sterile field and help you avoid touching un-prepared areas with your instruments. They also preserve body heat.  

5. Sterility 

Sterility is a key factor in surgical success. Proper layout of your space to keep “dirty” and “clean” separate, using clean, sterile gloves, autoclaved instruments and knowing what to do if something becomes contaminated all help to keep the process smooth, prevent infection and aid in recovery.  

6. Instrument handling

The tips of delicate rodent surgical instruments should be inspected for damage before using. Instruments should be autoclaved in a surgical pack and kept in that pack where possible and not laid out on the surgery table.   

Instruments should be kept away from non-sterile surfaces throughout the surgery and should be re-sterilized once contaminated (e.g. if accidentally touching a non-sterile surface) using a hot bead sterilizer.   

The “tips” technique, where just the tips of instruments are kept sterile, is recommended. It is useful when you’re working alone and touching non-sterile objects (e.g., anesthesia machines, microscopes, lighting) is recommended. 

7. Monitoring anesthesia

Many factors affect the amount of anesthetic required. As a general rule, a smaller species may require somewhat higher dose for induction and maintenance than a larger species because they are able to metabolize it more rapidly.  

Once a surgical plane of anesthesia is reached and surgery has begun, the animal will require constant monitoring every 5-10 minutes, typically done with a “toe pinch” to see if any movement is stimulated. You can also monitor ear pinna reflexes, eye lids, whisker twitching, mucous membrane colour and changes in breathing patterns, to name a few.  

Typically, If an animal is too light, stop and adjust the anesthesia. Continuing surgery can cause further wakening as the animal is stimulated.  

If an animal is too deep and begins gasping, stop and turn off the anesthetic flow. Allow the animal to recover slightly with oxygen before turning back on or continuing.  

8. Surgical technique

Tissues should be handled gently avoiding unnecessary trauma or drying out. Wounds should be closed with appropriate suture material and techniques using the right kind of needles. Good surgical techniques will prevent post-surgical complications like infection, dehiscence, hemorrhage or even death.  

9. Post-operative care

Your surgical suite should have a designated recovery area with a clean cage lined with paper towel and access to heat support. The animal should be monitored and stimulated until it is able to right itself.  

Fluids are lost during surgery for a variety of reasons, so it is important to give more fluids post operatively to aid in rehydration and speedier recovery.  

Apply eye lubrication at the beginning of surgery, as mentioned, during surgery if it is prolonged and when the animal is in recovery to aid in keeping the cornea moist and avoid accidental injury from prolonged dryness.  

Animals should be monitored closely for several days following surgery and given nutritional support, analgesics, fluid therapy and heat if needed.  

10. Record keeping and clean up

Proper surgical and post-surgical records should be maintained. All indicated animal information, medications given and anesthetic records are required.  

When surgery is complete and the animal is recovered, you should give your surgical space a thorough cleaning and disinfecting. Keeping the space clean and ready for future use helps to keep you organized and prepared.