How is KTT performed on a cat? - briefly
KTT (Kidney Transplant Trial) in cats involves surgically removing a kidney from a healthy donor cat and transplanting it into a recipient cat with renal failure. The procedure requires precise technique, including careful handling of tissue and meticulous suturing to ensure graft survival and proper function.
How is KTT performed on a cat? - in detail
Keyhole thoracoscopic thymectomy (KTT) is a minimally invasive surgical procedure performed on cats to remove the thymus gland, which can be enlarged in cases of feline hyperthyroidism or other conditions. The detailed steps involved in performing KTT on a cat are as follows:
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Preoperative Preparation: Before the surgery, the cat undergoes a thorough physical examination and diagnostic tests such as blood work, urinalysis, and imaging studies (e.g., X-rays or ultrasound) to assess its overall health and identify any potential complications. The cat is also fasted overnight to ensure an empty stomach during the procedure.
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Anesthesia Induction: On the day of surgery, general anesthesia is administered to the cat. This typically involves intravenous administration of anesthetic agents and the use of an endotracheal tube for continuous delivery of oxygen and anesthetic gas during the procedure.
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Surgical Site Preparation: The surgical site, usually the neck area where the incision will be made, is clipped of hair and cleaned with antiseptic solutions to prevent infection. Sterile drapes are used to cover the cat and maintain a sterile field around the operative area.
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Incision and Access: A small incision, typically less than 1 cm in length, is made on the neck, usually on the right side. Through this incision, access to the thoracic cavity is achieved using specialized instruments such as a trocar and cannula.
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Insufflation: Carbon dioxide or another insufflating gas is introduced into the thoracic cavity to create a pneumothorax, which expands the space within the chest and allows for better visualization of the thymus gland using the thoracoscope.
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Thoracoscopy: A thin, flexible thoracoscope equipped with a camera is inserted through the cannula. The images from the thoracoscope are displayed on a monitor, providing the surgeon with a clear view of the internal structures.
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Identification and Dissection of the Thymus: Using the visual guidance provided by the thoracoscope, the surgeon carefully identifies the thymus gland, which is typically located near the heart and great vessels. Specialized instruments such as graspers and scissors are used to dissect and remove the thymus gland.
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Hemostasis: During the dissection process, small blood vessels may be encountered. These are cauterized using electrosurgical instruments to achieve hemostasis and prevent excessive bleeding.
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Specimen Retrieval: Once the thymus gland is completely removed, it is placed in a specimen retrieval bag and carefully extracted through the small incision on the neck.
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Chest Drainage: A chest tube may be inserted to drain any residual air or fluid from the thoracic cavity. This helps to restore normal lung function and prevent complications such as pneumothraces.
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Closure: The incision site is closed using sutures or surgical staples, and a sterile dressing is applied. The cat is then transferred to the recovery area for close monitoring during the postoperative period.
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Postoperative Care: After the surgery, the cat receives pain medication and supportive care as needed. This may include intravenous fluids, antibiotics, and regular checks of vital signs and wound healing. The cat is typically monitored until it can eat and drink on its own and shows no signs of discomfort or complications.
Throughout the procedure, careful attention is paid to maintaining a sterile environment, minimizing tissue trauma, and ensuring the safety and comfort of the cat. KTT is generally considered a safe and effective method for thymus gland removal in cats, with most cats recovering quickly and returning to normal activities within a few days.