 |
Insert a small probe, hemostat, or balloon-tip catheter into the anal sac. Make an incision at the lateral aspect of the anal sac and carefully dissect the sac from the sphincter muscle fibers. Ligate the duct near the oriface. |
ANAL SACCULECTOMY
GENERAL INFORMATION
- Anal sac disease occurs most commonly in small dogs, less commonly in large dogs or cats.
- Animals with anal sac impaction or infection should be treated medically prior to anal sacculectomy.
- Indications for anal sacculectomy include recurring anal sac impaction/abscessation and neoplasia.
- Submit excised anal sacs for histopathologic analysis.
- Potential complications include fecal incontinence, sinus tract development, tenesmus, and rarely perirectal stricture.
MOST COMMON COMPLICATIONS AND DIFFICULTY
- Poor familiarity with the surgical anatomy may lead to damage of the external anal sphincter muscle.
- Failure to remove entire anal sac. Continued secretion and fistulation may occur if any portion of the anal sac is not properly removed.
- Incontinence may occur if the anal sphincter is cut or damaged.
"EXPERTS' ADVICE"
- Risk of fecal incontinence and retention of remnant from anal sac can be minimized by identification of ventral extension of anal sac and selective dissection from fibers of anal sphincter, as opposed to opening anal sac along its entire length and cutting the anal sphincter.
- Carefully lift the sphincter muscle off the end of the anal sac to avoid having to cut it.
Careful dissection of the anal sac is essential in order to prevent fecal incontinence. The sac can be filled with latex or wax to facilitate dissection. Attempt to close the defect in the external anal sphincter with a mattress suture following removal of the anal sac.
ANAL SACCULECTOMY:
SUTURE AND NEEDLE OPTIONS
| Brand | Needle Type | Needle Reference | |||||
| Main Choice | Also Possible | Main Choice | Also Possible | ||||
| INTERNAL | MONOCRYL* | VICRYL* PLUS | Taper Point | RB-1, SH | SH-1, CT-3 | ||
| SUBCUTANEOUS | MONOCRYL* VICRYL* PLUS |
PDS* II VICRYL* |
Taper Point | RB-1, SH, CT-2, CT-1 |
|
||
| SKIN CLOSURE | ETHILON* PROLENE* |
Silk | Reverse Cut | FS-2, FS-1, FS | FSL, CP-2, CP-1, KS | ||
| Cat/Small Dog (20 lbs or less) |
Medium Dog (20-45 lbs or less) |
Large Dogs (50 to 75 lbs) |
Giant Dog (75 lbs +) |
|
| INTERNAL | 4-0 or 3-0 | 3-0 | 3-0 | 3-0 |
| SUBCUTANEOUS | 4-0 | 4-0 or 3-0 | 3-0 or 2-0 | 2-0 |
| SKIN CLOSURE | 4-0 | 4-0 or 3-0 or 2-0 | 3-0 or 2-0 | 2-0 |
Use the suture selection tool for specific product code recommendations.