April 24, 2009
The omentum is very useful in the abdomen as is. It can be even more useful in distant places by using a lengthening technique.
After exteriorizing the spleen and the omentum, the dorsal leaf is retracted cranially to free it up from the pancreas, where it attaches.
Hemostasis can be achieved with 3-0 or 4-0 PDS ligatures. When the dorsal leaf is extended caudally, you now have a wide, beautiful leaf of omentum.
Need an even longer flap?
You can create an inverted L-shaped incision caudal to the gastro-splenic ligament, on the left side of the patient. The left lateral half to two thirds of the omentum’s width is thus separated. Again, hemostasis is achieved with double ligatures. The caudal third of the omentum is preserved to insure vascularization of the pedicle.
The omental extension can now be used in various distant places through a tunnel, for example in the abdominal wall and under the skin. It can also be used in the thorax.
For a complete description, refer to Page 222 in the third edition of “Small Animal Surgery,” by T.W. Fossum (Mosby Elsevier, 2007). The chapter “Surgery of the Integumentary System” is written by Cheryl Hedlund.
It is important to keep the omentum moist at all times using warm, sterile saline.
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