1. Options for Teaser Bull Surgical Procedures
Kathy Whitman, DVM, MS
Great Plains Veterinary Educational Center

2. Gomer bull selection
Purpose: heat detection, synchronization, estrus induction
Mature, virgin bulls, free of STDs and other biosecurity risks
Structurally sound and sufficient size
Libido with limited human risk
Additional history?

3. Surgical preparation 24-48 hour fast for ruminating bovines
Physical exam
Does he have nuts??????
Anesthetic risk
Ancillary testing
PCV/TP
Anesthesia/analgesia/antibiotics
Positioning
Generally dorsal recumbency
Appropriate padding
Tilted for surgeon preference
Well restrained
Protect eyes

4. Surgical preparation Aseptic procedure!!!
Scrub and prep like you’re a surgeon and it matters
Clip-flank to flank, scrotum to xyphoid
Aseptic scrub, +/- drape
Clamp or purse string sheath to minimize urine contamination
Instrumentation/surgery pack
Sterile
Plan for worst case scenario-what would you require?
Suture choice
Scarring is good in most cases-do you want it to resorb?
Don’t put it where it’s not needed-ex. epididymectomy
Suture removal?

5. Surgery similarities Patient positioning Patient preparation
Be confident in making incision
Use scissors-better control, better hemostasis
Control hemorrhages as needed-take time to ligate
Limit time, trauma, and contamination
Reduce dead space if necessary
Continuous pattern for skin is sufficient
Sexual rest is required in all situations-up to 6 weeks if uncomplicated

6. Various surgical methods
Epididymis
Epididymectomy
Iatrogenic necrosis
Vas deferens
Vasectomy
Vasostomy
Penis
Penectomy
Penopexy
Phallectomy
Translocation

7. Epididymis Epididymectomy Emasculotome Caustic procedures
Can be performed standing with local block
Use in combination with other procedures
Emasculotome
A problem if proper clamp is not applied-per spermatic cord
Maintain libido?
Caustic procedures
Ethical?
Humane?

8. Vas deferens Vasectomy Vasostomy
Ligation and transection of the vas (ductus) deferens
Vasostomy
Transection and reattachment to exterior
Allows for evacuation of semen
Tedious and no clear advantage over vasectomy

9. Vas deferens-Vasectomy
Performed standing, lateral, or dorsal recumbency
Preparation of scrotal neck with local block
1-2 in vertical incision in neck of scrotum, proximal to testicle
Extend into tunica dartos to expose spermatic cord
Blunt dissection to continue through tunica vaginalis to isolate ductus deferens
Visualize cremaster, vein, and artery-AVOID ligating/transecting these
Two ligatures (absorbable, monofilament) 2 in apart, transect
Close tunics and skin

10. Penis/prepuce Penopexy (penile fixation) Penectomy Phallectomy
Penis is fixed to prevent extension-high and low options
Penectomy
Urethrostomy with penis removal-high and low options
Phallectomy
Amputation of distal penis
Translocation
Tunneling
Z-plasty

11. Penopexy (low) Surgical prep and line block
Identify preputial reflection
Use of a vaginal speculum to protect penis and identify reflection is useful
Incise caudal to reflection, lateral to penis
Using blunt dissection, isolate a 4-6 cm section of penis
Place 3 interrupted sutures (non- absorbable, #3) through the tunica albuginea of the dorsal penis
Again, avoid important structures
Secure to the linea alba
Simple interrupted to close skin
Rest 2-3 weeks

12. Penopexy Body Wall Linea alba Tunica albuginea
Non-absorbable suture, uninterrupted simple continuous

13. Penectomy/Phallectomy
Standing procedures
Use caudal epidural and pudendal blocks
+/- Light sedation
Keep urethra patent

14. Penectomy-”high heifer”

15. Translocation-Tunneling
Surgical prep and line block, block flank incision site
Circumferential incision around prepuce extending caudally to base of the scrotum-speculum as a guide and contamination control or purse string
Circular incision and removal of tissue cranial to flank fold (45 from distal aspect of midline incision)
Dissect penis within prepuce until it is freed from underlying tissues
Using uterine forceps or instrument of length, create a tunnel from the distal end of the midline incision
Place sterile sleeve or speculum thru tunnel
Draw penis through sterile apparatus and bring through flank hole
Suture subcutis (if needed) and skin

16. Penile Translocation-Z-plasty

17. Penile Translocation-Z-plasty

18. Surgical concerns… Bull waking up…
Hopefully you tied good knots…
Re-dosing is okay, do not compromise good technique for speed
Not sure where to cut or how to proceed?
When a problem presents itself, the time for preparation has passed
Stop, breath, ask questions
Bleeders
Unclamp yourself and clamp the bleeder-ligate as needed
Address this issue up front-surgical field will be poor if you ignore
Puckered skin when suturing
Remove “dog ears” when seal is complete
Remove suture and begin again
We’ll tease you if it’s ugly, we’ll be upset if it comes apart

19. Post surgical care
Return to recumbency should be rapid, but don’t rush to get them up
<30 min standing
Monitor for excessive bleeding and/or swelling
Appetite should be back to normal relatively quickly if pain management is appropriate and no complications

20. Post surgical problems
Typically minimal with z-plasty
Abscess, dehiscence, systemic infection, etc.
Iatrogenic urinary obstruction
Intromission still possible…
Discussion all potential issues with owner!!!!