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This Concept Map, created with IHMC CmapTools, has information related to: Left Side Abomasopexy Procedure, Step 15: Tie the suture strands with a surgeon’s knot. Leave the cut ends at least 8 cm (3 inches) long. You can place your hand between the abomasum and ventral abdominal wall and between the abomasal sutures to ensure that the suture material has the correct tension. Sutures tied too tightly will cut through the skin; sutures tied too loosely will allow displacement of the abomasum to recur. Step 16: Perform a routine three-layer closure of the abdominal incision. (As described in exploratory laparotomy. END, Step 3: Explore the peritoneal cavity thoroughly before the abomasopexy. Prepare the suture material. Step 4: Use heavy, No. 3 synthetic nonabsorbable material 180 to 200 cm (6 to 7 feet) long. Step5: Thread a straight 4-inch trocar point needle on each end of the suture material. Locate and mark the center of the suture material. Place sutures in the abomasum., Step 13: Remove the gas from the distended displaced abomasum with a large-gauge (12 to 14 gauge) needle attached to tubing leading out of the abdominal cavity with or without suction. Step 14:As the assistant places tension on the sutures, the surgeon pushes the abomasum into its normal position by using a kneading-like motion. Palpate carefully to ensure that no other structures (e.g., small intestine) are entrapped by the sutures under the abomasum. Step 15: Tie the suture strands with a surgeon’s knot. Leave the cut ends at least 8 cm (3 inches) long. You can place your hand between the abomasum and ventral abdominal wall and between the abomasal sutures to ensure that the suture material has the correct tension. Sutures tied too tightly will cut through the skin; sutures tied too loosely will allow displacement of the abomasum to recur., LEFT SIDE ABOMASOPEXY PROCEDURE INVOLVES THE FOLLOWING STEPS: Step 1: Use a regional, fenestrated, moisture-repellent sterile drape. Stabilize the drape to the left paralumbar area with towel clamps., Step 1: Use a regional, fenestrated, moisture-repellent sterile drape. Stabilize the drape to the left paralumbar area with towel clamps. Step 2: Make a modified muscle-spreading abdominal incision. Step 3: Explore the peritoneal cavity thoroughly before the abomasopexy. Prepare the suture material., Step 9: Placement of sutures through the ventral abdominal wall. Each end of the abomasal suture material will exit the ventral abdominal wall. These ends are tied outside the abdominal wall to secure the abomasum to the ventral abdominal wall. Step 10:While you protect the needle point in the palm of your hand, insert your arm along the lateral body wall between the peritoneum and the displaced abomasums until you palpate the xiphoid area. Step 11:Force the point of the anterior needle ventrally through the body wall (the area previously prepared). A surgical assistant should guide you to the proper location. A surgical assistant should grasp the needle outside the body wall and exert slight to moderate traction., Step 11:Force the point of the anterior needle ventrally through the body wall (the area previously prepared). A surgical assistant should guide you to the proper location. A surgical assistant should grasp the needle outside the body wall and exert slight to moderate traction. Step 12:Repeat the process with the second (caudal) needle and suture, placed about 8 cm (3 inches) caudal to the first. Step 13: Remove the gas from the distended displaced abomasum with a large-gauge (12 to 14 gauge) needle attached to tubing leading out of the abdominal cavity with or without suction., Step 7: Place running sutures in the abomasum for a distance of approximately 8 cm (3 inches). Sutures bites should be at least 2 cm (1 inch) long. The suture pattern may be simple continuous, Ford interlocking, or zig-zag Step 8: Pull about half the suture material through the abomasal wall to the previously marked center of the material. The completed line of sutures will be about 8 cm (3 inches) long in the abomasal wall, and a long strand of suture material will be at each end of the suture line. Step 9: Placement of sutures through the ventral abdominal wall. Each end of the abomasal suture material will exit the ventral abdominal wall. These ends are tied outside the abdominal wall to secure the abomasum to the ventral abdominal wall., Step5: Thread a straight 4-inch trocar point needle on each end of the suture material. Locate and mark the center of the suture material. Place sutures in the abomasum. Step 6:Grasp one of the two needles while maintaining the second needle outside the body. While you cradle and protect the needle, carry the needle and suture material intra-abdominally to the dorsocranial aspect of the displaced abomasum. (This area of the displaced abomasum should constitute the ventral, cranial, and fundic portion of the abomasum when it is in its normal position.) Step 7: Place running sutures in the abomasum for a distance of approximately 8 cm (3 inches). Sutures bites should be at least 2 cm (1 inch) long. The suture pattern may be simple continuous, Ford interlocking, or zig-zag