Chapter 6: Table of Contents
Ligate the Pedicle
Pedicle ligation is performed using absorbable suture such as PDS®, Vicryl® or Biosyn.® While size 2-0 or 3-0 suture material is most commonly used, size 0 suture is sometimes necessary to ligate very fatty pedicles in mature, large or giant breed dogs and size 4-0 suture material is sometimes ideal for very small cats or immature small breed dogs. First, apply a circumferential ligature within the crush created by the clamp farthest from the ovary (C1). Then, apply a transfixing suture (medium / large dogs) or circumferential (small dogs and cats) suture between the first suture and the second clamp (C2). Ligatures should be no more than a few millimeters apart (those tissues will be ischemic). ‘Flashing’ the second clamp may be necessary to ensure a tight ligature is applied. This is especially important for large / fatty pedicles or when your ligature is very close to the clamp because the clamp might prevent the pedicle from collapsing within your ligature. Avoid including the omentum or other tissues in your clamps or ligatures as this may lead to suture loosening and slippage. This is especially common on the right ovarian pedicle. Before transecting the ovarian pedicle, examine your ligatures and replace any sutures that appear loose or are placed incorrectly.