Surgical Services

Definitions: Major vs. Minor Surgical Procedures

Minor surgery is any invasive operative procedure in which only skin or mucus membranes and connective tissue is resected e.g. vascular cutdown for catheter placement, implanting pumps in subcutaneous tissue. Procedures in which the surgical field cannot be effectively disinfected, e.g. tooth extractions and gingival grafts, will generally be considered minor. This category also includes biopsy, an invasive operative procedure for procurement of tissue samples or body fluids using a needle or trocar.

Major surgery is any invasive operative procedure in which a more extensive resection is performed, e.g. a body cavity is entered, organs are removed, or normal anatomy is altered. In general, if a mesenchymal barrier is opened (pleural cavity, peritoneum, meninges), the surgery is considered major. For surgical procedures that do not clearly fall in the above categories, the chance for significant inadvertent microbial contamination is to be a primary consideration. Generally, the classification of major will be applied only to procedures in which the animal is anticipated to survive longer than 24 hours. If the animal is to be terminated in less than 24 hours, techniques applicable to minor surgical procedures may be used. A procedure previously classified as minor will be changed to major if microbial contamination proves to be a significant problem. In general, the standards for major surgery apply only to non-rodent species. However, if microbial contamination proves to be a significant problem with procedures carried out in rodents, the standards for non-rodent species must be applied.

All major surgical procedures in non-rodent species must use appropriate surgical techniques and must be conducted in facilities intended for survival surgery and used only for that purpose. The facilities must be designed and managed to insure a level of sanitation appropriate for aseptic surgery. The operating room should contain only the equipment and supplies required to support the procedure being performed. A separate area, apart from the surgery room, must be provided for preparing the animal for surgery although the final surgical preparation, not to include clipping of hair, may be conducted in the surgery. An area equipped with surgical scrub sinks should be apart from the operating room. A surgical-support area should be provided for storing instruments and sterile supplies and for washing and sterilizing instruments.

The classification of major or minor for each proposed surgical procedure will be determined by the IACUC committee.

DAR Facilities for Major Surgery

SURGICAL SUITES

DAR manages a surgical suite at the Rollins Center (G53C, G53D). These resources may be used for major or minor procedures, survival or nonsurvival surgical procedures, and surgical dissections of cadavers. Two to four survival procedures and up to six nonsurvival procedures can be done in the surgical suites in the Rollins Center. In addition, DAR assists in support of imaging procedures in the WMRB (B013).

  
RESERVATIONS

Scheduling of the surgical resources is done during normal business hours and on a first come, first serve basis by the DAR Veterinary Technical Office, 404.727.3685. Scheduling of imaging facility use should be done through nuclear medicine.

Large Animal Surgery Suites by contacting Andrey Krasnopeyev at 404.727.3685 or akrasno@emory.edu.


SITE VISITS

We recommend that new users schedule tours of the facilities and review the instruments and supplies, such as suture, that are normally stocked.


EQUIPMENT AND SERVICES PROVIDED BY THE DAR

Common Materials

  • Common general laparotomy and thoracotomy surgical instruments
  • Gas anesthesia (isoflurane)
  • Controlled ventilation for single animals up to 100 kg and multiple animals weighing less than 50 kg
  • Electrocautery
  • Suction
  • Continuous rate infusion
  • Monitoring Devices: pulse oximetry, capnograph, ECG, blood gas analysis, body temperature, direct and indirect blood pressure
  • Radiography (Rollins Center only)
  • Steam autoclave
  • Consumable supplies: gowns, drapes, gloves, blades, fluids, and bandaging materials


Special Equipment and Material

With sufficient notice, special arrangements can be made for:

  • Single lung intubation
  • Nitrogen for orthopedic drills
  • Mayo stand covers
  • Surgical staplers
  • Ethylene oxide gas sterilization

Technical Services

The veterinary staff can provide pre- and postoperative care, anesthesia and intraoperative technical services, and other services such as euthanasia, injections, phlebotomy, medication administration, sedation, bandaging and other care. Arrangements for services can be made at the time of scheduling 404.727.3685.


EQUIPMENT THAT IS NOT PROVIDED

Investigators must make their own arrangements for C arms and compatible tables, stereotactic devices and specialized surgical instruments such as those required for vascular, orthopedic, endosurgical, or neurosurgical procedures. Special arrangments must be made with the Anatomy Department for human cadaver procurement.


DAMAGE POLICY

Outside of the bounds of normal wear, users are responsible to keep equipment in good working order. Of particular concern is the use of electrocautery units which are subject to excessive usage. The bovies should not be activated for more than seven seconds at a time.

Multiple Survival Surgery

  • Multiple survival surgical procedures on a single animal are greatly discouraged.

  • Cost alone is not adequate justification for performing multiple-survival surgical procedures.

  • Multiple major surgical procedures may be permitted provided they are related components of a research or instructional project, are approved by the IACUC, or are necessary to protect the health of the animal.

Post-Operative Care

  1. The postoperative recovery period is a critical time; planning for this period should occur prior to initiating surgery. Investigators are responsible for the postoperative care of their animals, including care after the normal working hours, on weekends and on holidays. The specific parameters that should be monitored are dependent upon the procedure, species of animal, and anesthetic agents used and are left to the discretion of the investigator in agreement with the IACUC.

  2. Assistance with postoperative care may be provided by the technical personnel of the Division of Animal Resources. Such assistance should be arranged prior to surgical procedures.

  3. Postoperative care must be such to minimize discomfort and the consequences of any disability from the operative procedure.

  4. Post-surgical animals should be euthanized if it is determined that their postoperative condition is causing them to suffer pain or distress needlessly.

  5. Consultation on post-operative care is provided by the staff veterinarians. The veterinary staff must be contacted when there are postoperative complications and the animal is not euthanized.

  6. Postoperative care records must be continuously accessible to the veterinary staff and site visitors from the IACUC, AAALAC, the USDA (for nonrodents) and other regulatory bodies. Additionally, the date of surgery should be noted on the cage card.

  7. The immediate recovery from anesthesia should be monitored closely. Animals should be monitored continuously until they are able to maintain sternal recumbency. Rodents should never be returned to regular housing until they are recovered from anesthesia. Following restoration of consciousness, the animal should be examined at least daily for a minimum of ten days. Exposed sutures or staples should be removed within 10-14 days of the surgery. Specific written guidelines for the monitoring of postoperative animals are available from the clinical veterinary staff.

  8. The Division of Animal Resources will provide appropriate postoperative care to animals that are found to be receiving inadequate care. The investigator will be responsible for manpower and materials expenses incurred during these instances.