Surgical Procedures in the pig

Caesarian Section

	The pregnant uterus will be very large. Each uterine horn can reach 2 metres. There is the possibility of 12 plus piglets.
	Preparation: Clean pig. It might be necessary to carry out the surgery in the farrowing crate. In pet pigs a full anaesthesia masking the pig down with gas (isoflurane) would be the method of choice. Sedation and anaesthesia Sedation is difficult as the piglets will be affected by the sedation. Where possible the sow can be sedated with Stresnil – Azaperone and the sow anaethetised by local infiltration of the skin incision with lidocaine.
In pet pigs- propofol intravenous can be use 6 mg/kg. Note this can cause apnoea so a method of manual ventilation is required.		If gaseous anaesthesia is required, use intranasal intubation to administer the isoflurane. Note pigs may be halothane sensitive resulting in PSS

	In commercial breeds (Landrace or Large White) position A is preferred. The incision is made some 12 cm above the teat line (one hands width). This access is used to minimise the amount of subcutaneous fat. In addition the three abdominal muscle layers have merged into one layer. During the subsequent suckling the wound is away from the piglets.
Drawing showing the positions of the incision to gain access to the abdomen.
Incise through the skin and muscle layer to the peritoneal layer. Penetrate the peritoneal layer with a scapel blade and then using scissors extend the incision.	The uterus is normally very obvious within the abdomen. Remove part of a uterine horn with a piglet inside.
Incise the uterus over the back of the piglet. Take care not to incise into the piglet.	Remove the piglet and pass to an assistant to encourage respiration. Clear the airways and if necessary use a respiratory stimulant.
Hold the edges of the incised uterus.	Remove adjacent piglets, higher and lower from the incision. Do not attempt to remove all the piglets through the one hole. Three piglets per uterine incision is adequate.
Close the uterine incision using an inverted Lambert stitch and absorbable suture such as PDSII or catgut.	An inverted lambert stitch.
Close the peritoneum cavity with Vicryl or PDSII	Close the muscle layer as one layer. Close the subcutaneous
Close the skin with Vicryl using a subcutaneous pattern.	Care for the piglets. Do not allow them to suckle until the sow has reasonably recovered. Provide the piglets with warmth and syringe with a small amount of warm water.
Do not provide any milk products as this may interfere with colostrum antibody gut transfer which stops within 6 hours of first milk access.. Providing the piglets with colostrum from another sow may be useful	The healing skin incision 2 days post -caesarian