Exotis ISSN 2398-2985

Reptiles

Cloacopexy / colopexy

Synonym(s): Colonopexy

Contributor(s): Agata Witkowska, David Perpinan

Introduction

  • Cloacal prolapse Cloacal organ prolapse is a protrusion of one or more of the cloacal organs through the vent, often caused by an underlying disorder. Common causes of cloacal prolapses include physical obstructions such as uroliths and egg binding as well as parasitism and nutritional secondary hyperparathyroidism.
  • In acute, noncomplicated cases, prolapses can be replaced manually Cloaca/colon manual replacement and managed by correction of underlying cause.
  • Cloacopexy and colopexy are invasive techniques requiring flank or midline celiotomy Celiotomy and can be a challenging procedure in certain animals.
  • A technique for percutaneous cloacopexy has been described in snakes and lizards and is provided here. This approach does not allow for good visualization of the celomic structures.

Uses

  • In cases of recurrent cloacal prolapses non-responsive to medical management/external sutures and where the primary underlying cause has been treated or is unknown.

Advantages

  • Allows for visual inspection of other coelomic organs, which may not be possible with diagnostic imaging such as radiography and may be limited without access to computed tomography.
  • Celiotomy Celiotomy allows for other surgeries to be performed at the same time. This is beneficial in cases such as egg binding where salpingectomy can be performed at the same time as a cloacopexy or colopexy. In cases of uroliths, cystotomy can be performed during the same celiotomy as colopexy.

Disadvantages

  • Requires moderate surgical experience and familiarity with anatomy of the species operated on.
  • For species requiring plastronotomy special equipment is needed, eg bone saw.
  • Risks of general anesthesia.
  • Longer recovery time than with external vent sutures such as purse string sutures.
  • Risk of post-operative complications due to involvement of the celom; bleeding, accidental damage to other organs, higher risk of infection than with external vent sutures.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Guarded to poor dependent on findings during celiotomy and underlying cause.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Knotek Z & Cermakova E (2017) Reproductive medicine in lizards. Vet Clin North Am Exotic Anim Pract 20 (2), 411-438 PubMed.
  • Chai N (2016) Surgery in amphibians. Vet Clin North Am Exotic Anim Pract 19 (1), 77-95 VetExotic.
  • Girolamo N D & Mans C (2016) Reptile soft tissue surgery. Vet Clin Exot Anim 19 (1), 97-131 PubMed.
  • Alworth L C, Hernandez S M & Divers S J (2011) Laboratory reptile surgery: Principles and techniques. J Am Assoc Lab Anim Sci 50 (1), 11-26 PubMed.
  • Norton T M (2005) Chelonian emergency and critical care. Semin Avian Exotic Pet Med 14 (2), 106-130 SemanticScholar (pdf download).
  • Bodri M S & Sadanaga K K (1991) Circumcostal cloacapexy in a python. J Am Vet Med Assoc 198 (2), 297 PubMed.

Other sources of information

  • Doneley B & Johnson R (2017) Diseases of the Gastrointestinal System. In: Reptile Medicine and Surgery in Clinical Practice. Wiley & Sons, UK. pp 280-283.
  • Chitty, J & Raftery A (2013) Prolapse. In: Essentials of Tortoise Medicine and Surgery. Wiley-Blackwell, UK. pp 270-273.
  • Meredith A & Johnson-Delaney C (2010) Common Conditions. In: BSAVA Manual of Exotic Pets. 5th edn. Eds: Meredith A & Johnson-Delaney C. BSAVA, UK. pp 302, 311.
  • Bennett R A, Fitzgerald K T et al (2006) Surgery. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D R. Saunders Elsevier, USA. pp 581-630.
  • Bennett R A & Mader D R (2006) Cloacal Prolapse. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D R. Saunders Elsevier, USA. pp 751-755.
  • McArthur S (2004) Problem-Solving Approach to Common Diseases. In: Medicine and Surgery of Tortoises and Turtles. Eds: McArthur S, Wilkinson R & Meyer J. Blackwell Publishing, UK. pp 309-314.


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